Health and Wellness Show 01-18-25

Episode Transcript

Speaker 1 (00:15):
I've been hanging out with us now for a while
for the Home Improvement Show of the Midlands. Thanks for
sticking with us and just joining us. Good morning to
you and then welcome in time for the Health and
Wellness Show on one O three point five FM and
five sixty AM WVC and of course as always anywhere
you go on the totally free and revamped beautiful iHeart
Radio app. My name is Gary David. Coming up. We'll

(00:37):
be talking a little bit later on again this morning
about the issue with EDNA lex and Medical Center and
folks who that was. That was their choice for a
Medicare advantage plan and LMC was their provider of choice. Well,
the issue with that and if you found yourself stuck
in that, what you can do, what your options are.

(00:59):
Jeff Howe from overt Health Markets, it's going to be
talking about that again this morning. Jim's now also going
to drop bypass a visit. He'll be here in the
next half hour. We get the program underway this morning
on this uh Saturday with John Farley and Matthew Terry
from Preservation Specially. Let's get more and see you. Good
to see both again.

Speaker 2 (01:15):
Garry, how are you good?

Speaker 1 (01:16):
Morning, Good morning to you. So, yeah, two weeks ago
we talked about you know, brand new year resolutions, you know,
get started a lot of people and some have already
fallen off that bandwagon, of course, but we talked about
the importance of that and planning for your retirement, which
is what you guys specialize in. It's preservations specialists preservation
you know. Come on, but we haven't done this in

(01:38):
a little while, and maybe maybe we can sit down
and talk today about the wide variety of services that
you offer. I mean, you know, we talk about yeah,
your default, well, talking about my money, well yeah, but
there's a there's there's a lot of different things to
be you know, to look at here, and a lot

(01:59):
of different ways that you help people plan for and
be successful in their retirement years. A lot of things
that you do. So let's then we can talk about
some of those this morning.

Speaker 3 (02:09):
Yeah, I mean, so we work in five areas. In
the first the first that we work in is income, right,
because if you don't have an income, you don't have
a retirement. So we want to make sure that that's covered, okay,
and so how do we you know, we have a
comprehensive income plan that says, Okay, this is going to
carry you for the next thirty years. Because you know,
it turns out when you look at these these stats

(02:30):
on how long does the average man and woman live
in the United States, right, they're factoring in all the
people who who passed early. Right, So if you make
it skew the five they are because you make it
to sixty five, you've got a long run for most people, right,
you got a long run. So we want to make
sure that we have a good income plan in place
that accounts for any contingencies in anything that can happen

(02:54):
in the future. So we make we make a nice
income plan, and in that income plan, it's going to
take into account things like inflation, because you know, twenty
dollars today twenty years from now is only going to
buy ten dollars worth of goods, right, it's it's it's
about half the amount.

Speaker 1 (03:12):
So the yeh twenty dollars a day was forty dollars
four years ago.

Speaker 4 (03:14):
But yeah, yeah, yeah, yeah, yeah, right, yeah, that it is.

Speaker 3 (03:17):
Yeah yeah, so yeah, that's that's how that goes, right,
So we got a factor in for the inflation, right,
So that's one of the things so, but there are
many areas that we work in, and so we we
obviously we talk about investments. We do that insurance if
you need it. So insurance is and and probably the
biggest thing to discuss there. There are there are different avenues,

(03:37):
but people who are looking to leave some assets to
their errors, there are different types of insurances we can
use to make that happen. Another one that we want
to discuss too is long term care because in this country,
we are responsible for our own long term care coverage.

Speaker 1 (03:52):
Yeah.

Speaker 3 (03:53):
Yeah, it's not cheap and and you know you do
the math on that, and and so so and there
are and and you know, planning be really easy if
we knew the outcomes, right, we don't, so we got
to make our best estimated. We got to do that
sort of thing. So those are a couple of the
areas that we work in. And then of course we
do estate and taxes, right. But I think that the

(04:15):
biggest thing is if you come visit us, first two
meetings are no cost, no obligation. We're asking you a
bunch of questions in the first meeting, and we are fiduciaries,
that is, we're not recommending anything to you that is
not in your financial best interest. We don't have any quotas,
we don't have anything like that. We are licensed in
everything that's available. So what we do is we sit

(04:36):
down and we try to assemble a put the puzzle
together for your individual case and for your family. So, yeah,
first meeting a lot of questions. Second meeting, we have
more questions, but also at kind of a high level
idea of where we think you stand and where we
could help you or not. I mean, there are sometimes

(04:57):
people come in and they're completely buttoned up and we're like, listen,
God bless you, you're doing great, keep doing what you're doing.
I would say that's probably not most people, but that
happens once in a while.

Speaker 2 (05:08):
Yeah.

Speaker 1 (05:09):
And then what happens when somebody comes in and he
you're like, uh, you know, it's this is gonna be
difficulty because you have those Yeah.

Speaker 5 (05:21):
Absolutely, you know. From time to time, we you know,
we we we come across those situations. And obviously, as fiduciaries,
our job is to absolutely and and and sometimes the
truth hurts, but honestly it's better that they hear it
now then just ignore it and they kind of be
in a in a rough situation in the future. So, yeah,

(05:43):
it's our job to to be that person to sometimes
deliver the news that we're not exactly looking for or
that person may be looking for as well. But yeah,
we'll sit down, we'll tell them what they need to do,
what changes they need to make, and we'll create a
plan and say, hey, you need to uh to be
very specific and stick to this plan if you wish
to have some sort of enjoyable retirement in the future.

Speaker 1 (06:05):
So income, insurance, long term care, estate planning, taxes, yep.
So obviously you guys aren't just like stockbrokers.

Speaker 5 (06:18):
We are absolutely not.

Speaker 2 (06:21):
Yeah.

Speaker 5 (06:22):
Yeah, So you come into our office, we talk about
our custom built retirement review, and the benefit of working
with the financial planner is we are exactly not what
you said. We are not a stockbroker. We are not
someone who only cares about your investments. And this says, hey,
you know those other four areas regarding your income generation

(06:44):
and your taxes and your in state and your insurance. Hey,
you figure all those out. We'll only focus on managing
your investments. No, that's not what we do here within
our office. We understand that everything fits together in one
big plan, and we want to make sure that you're
button up at all times to feel good about where
you stand now and where you're projected to be in
the future.

Speaker 1 (07:04):
I'm just curious because you mentioned insurance and as a
as a vehicle to to leave you know, assets for
your kids, grandkids, et cetera. I think most people think that, well,
this is what my investments are for. What have you?
I mean to leave it? Is there an advantage to
doing it another way?

Speaker 3 (07:24):
Depends on your circumstance. Sometimes there is, sometimes there isn't,
and we just have to look at the details, right.
So so sometimes people say, I mean, you know, a
simple example, Sometimes people say they want to leave, they
want to leave a certain amount to uh, you know,
to to certain errors and so you can get some
forms of life insurance that would that would take care

(07:45):
of that. And remember there's no tax consequence on like
life insurance. Everything that goes out is completely you know,
you're you're you're good to go. But sometimes that doesn't
matter because certain times, if you have holdings that are
outside of an IRA then uh uh for example, you know,
you have maybe a lot of stocks and certain things. Uh,

(08:06):
if you are at your passing, that goes to your
heirs at that at whatever the value was on the
day of your passing. So so there anyway, so you
have to look at the whole piece and say does
this make sense? Sometimes it makes a lot of sense.
Sometimes it makes no, it really doesn't. But but you
have to look at the at the details.

Speaker 1 (08:22):
Yeah. And at a time when you know, most American
workers they they're they've they've got money saved up in iras.
There's that tax tax consequence.

Speaker 4 (08:30):
Yeah, it absolutely is. Yeah.

Speaker 1 (08:32):
Yeah, yeah, so you're going to well you're still got
to take the hit now in your lifetime, right if
you want to move that money into say an insurance
policy of some sort. Yeah, they get it now. But yes,
the hits coming sooner or later. It's either for yours
or for your kids. Yeah.

Speaker 3 (08:46):
And and and we made the observation that that you know,
most economists believe that, uh and and I you know,
you could make this observation that right now, income tax
rates are still the lowest they've been in and Gary,
you're in my lifetime. You know, they're low. They're very low.
Even though people you know, you ask people and they say,

(09:07):
what are the times, Oh, they're so high, they're so high,
and I'm like, look at this chart.

Speaker 4 (09:10):
I mean, look at look at what happened.

Speaker 3 (09:11):
You know, even in the you know, when Reagan came
in in the eighties, he lowered them from seventy to fifty.
You know what I mean. I mean, think about that, right,
I mean those are those are the income taxes. So
you know, we're nowhere near that right now. So the
idea is that that they're probably at historically low times
low low values right now, low rates. So we can

(09:34):
take advantage of that and and do some planning with that.

Speaker 5 (09:37):
And John's you know, spot on for for people that
come into our office as part of that custom built
retirement birth you. Whenever it comes to tax planning, we
want you to understand your overall tax pitcher, meaning all
the moneies that you have saved for retirement. We want
you to understand that if you were to pass away,
which of those assets would actually pass tax free, Which

(10:00):
of those would actually just be a tax bill that
you know, the inheritor would be have to be on
the hook for paying. And that fits into your state plan.

Speaker 4 (10:09):
Right.

Speaker 5 (10:11):
So that's exactly the reason that we say all things
are connected, because it truly is, you know, if you
say that, no, I want to be the person. I
want to be the one that go ahead and pays
the tax, because whenever I pass away and my children
inherit these funds, I don't want them to be on
the hook for paying it, right, you know. And then secondly,

(10:31):
I also believe that now, just as John said, tax
rates are at historical lows, so why not let's go
ahead and pay taxes now. That way that if tax
rates do go up in the future, on essence, I'm
saving my future son or daughter money as they're not
having to pay taxes at the higher rate.

Speaker 1 (10:50):
So yeah, yeah, yeah.

Speaker 3 (10:51):
And the other thing is, I mean, it all depends
on what on what people's goals are. And in the
circumstance I remember I was working with this one guy
and I and I showed them the tax advantage of this,
and he goes, so the.

Speaker 4 (11:01):
Kids are gonna have to pay that. I don't care.

Speaker 3 (11:02):
So in it just depends on who you are and
what you are. So we sit down and we say, okay,
look at what are your goals. We'll go through this.
And really the biggest thing in all of this is,
no matter what, we want you to have peace of
mind to enjoy your retirement, and we want you to
have peace of mind that at your passing, your wishes
are preserved and things are done the way you want

(11:23):
it to be done. So this is, you know, the
whole it's all about. It's all about, look at you've
worked your butt off to get where you are. In
most cases, well now we want to make sure that
you're good and you can you can walk away calmly,
peacefully knowing that everything's buttoned up.

Speaker 1 (11:40):
There's no magic number. But I remember late last year
there was a survey and I think it was more
of gen z Ors, so you'll talk talk about this
with you, mister Terry, about how much money they felt
like they had to have in retirement in order to
be able to have an enjoyable retirement. And the number was,
I think two and a half million dollars. Yeah, something
along those lines. You know, there was a time when

(12:02):
we thought, well, if we can, if we can put
aside a million dollars in assets, we're good to go.

Speaker 2 (12:05):
Yeah.

Speaker 1 (12:05):
I mean, there's no magic number obviously mm hm, and
no one size fits all, but of you probably get
that question a lot. How much do I really need?

Speaker 4 (12:18):
Yeah?

Speaker 5 (12:18):
And you know, as as we say all along, it's
truly not just getting to X amount of dollars, because
that doesn't guarantee that you're gonna be okay, just given
the fact that you know, each person's goals and what
they're looking to accomplish is just a little bit different.
You know, if someone says that I do want to
take those three to four you know, non domestic trip

(12:41):
per year, well, obviously that's going to be very costly.
And for someone as as that person, you know, they're
they're gonna need to have a little bit larger nest
egg if if they're gonna be okay. But if someone says, hey,
you know what I've I've lived a great life. I
got to travel some while I was working, love to
play golf. I just want to play golf, hey out
on a back porch at home and you know, spend

(13:02):
time with the family and grandchildren. Hey, you know, that's
that's a that's a dream that they have, and each
person's dream is just a little bit different. And we
just want to talk to you through that so you
feel confident, as John said, whenever you step away.

Speaker 1 (13:14):
One of the again you mentioned long term care. Newsflash,
if you haven't been in a situation with a family
member who's had to be in long term care. It
is a lot of money, Yes, a lot of money.
Are there any any ways? I guess the only way

(13:34):
to save or you know, to get into long term
care that's not outrageously expensive is to actually take policies
out earlier in life.

Speaker 3 (13:44):
Right, well, yes, yes and no, because because the so
the traditional long term care policy is something that most
people know, which is very much. It's just like your
homeowners are auto insurance, right, you pay a certain amount
on a monthly basis, you hope you never need it,
and then when you do, you know, okay. Now, what
has happened with those policies over the years is that

(14:04):
they've become really really expensive that there's no virtually no
limit to how much the rate can go up on
a yearly basis. So we get people who come in
and they're in their seventies and you know, twenty percent
increase this year, and then next year it's a ten
percent and then I mean these are huge, huge numbers.
There are ways to work around that. Now, so there
are different policies that you can get that are different

(14:26):
than these things that yes, that you can do either
a lump sum or you can do like a pay
X over ten years and that's it. There is no
chance that that rate is ever going up ever again.
And you can have inflation rids, meaning that these things
so that you know long term care is going to
cost so much this year, but with inflation, it's going
to cost more next year and so on, So we
can build those things in and you can get some

(14:48):
peace of mind. Like it's quite common that what we'll
do with folks to say, okay, here's your whole situation.
We're going to take this much money and set of
the side and we're going to take care of a
couple of policies, one for each of you if it's
a couple, and say, okay, you all are good to go.
And there are certain other things that you want in
those policies that really give you peace of mind. For example,
if you're in your eighties, in your nineties or so,

(15:10):
you know you're getting up there and you now need
long term care, you do not want a policy that
requires you to send receipts in No, you got to
track down receipts. You gotta get it, you gotta no right.
You want a policy that as soon as you need
that that that money goes into your bank account and boom,
you spend it any way you want. Right, So there

(15:30):
are a lot of different ways to do this. It's
kind of like as things have evolved over the years,
these sort of policies have evolved, and again they can
give you peace of mind. And that's really what this
is all about. That Okay, you know that's where it is.

Speaker 5 (15:44):
John, You're exactly right. And I'll also add on. You know,
another one of the big benefits of the news style
of long term care policies that we have access to
is you know, we all hate wasting money, right, we
all hate paying for something and then you end up
just not using it. And the traditional form of long

(16:05):
term care policies, that's exactly what they are. It's a
benefit that you pay for, it's protection that you have.
But if you never use that, in essence, all that
premium that you paid for all those years, the insurance
company just keeps.

Speaker 2 (16:20):
You know.

Speaker 5 (16:21):
With the style of policies that John's referencing and the
style that we have access to, you know, sometimes you're
putting money in on a lump sum, or you're putting
money in over the course of a few years. But
if you never actually need those funds, you never actually
use you know, you never need need protection, which is
a blessing, right we all hope and prayer we don't
need long term care. But that then passes to your heirs.

(16:43):
So then you know, you feel like that you didn't
waste money for all those years, but what you did
was you bought peace of mind, right and upon your passing,
if you don't need it, it still goes to your
family members. So you're killing two birds with one stone,
and that's why and how we help our clients.

Speaker 1 (16:58):
That's great to right there. Well, I hope you got
a sends over the last fifteen minutes. Again, these guys
aren't stockbrokers. They are you know, financial planners, and too
many people don't understand the difference between the two. But
there's a huge difference. So the's a lot to digest
right there, whether it's you know, the income, the insurance,
the long term care, the estate planning, the taxes. You

(17:19):
want to sit down with these guys, how do they
get a hold of you and set up that appointment? John, Yeah,
it's a aight.

Speaker 3 (17:23):
Oh three nine retired eight oh three nine retire and
our office is off of Harveston and now the holidays
are over, the traffic is much less there.

Speaker 4 (17:32):
It's set.

Speaker 3 (17:33):
We're right near Harveston. We're between Piney Grove and Harveston
off at twenty six. You can see our office on
the on the side in the blue letters that says
Custom Build Retirement.

Speaker 1 (17:40):
Yeare you go all right? John Matthew, Good to see
you guys.

Speaker 4 (17:43):
Thanks Gerry, thank you. Hi.

Speaker 3 (17:45):
This is John Farling. Now let me ask you is
your retirement inflation proofd? Here's what I mean in retirement
chances are you run a fixed income with variable expenses.
So how do you not run out of money when
the cost of just about every thing continues to go up?

Speaker 1 (18:02):
You inflation proof it.

Speaker 3 (18:03):
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Call us today at ATO three nine Retire to learn more.
Inflation could take a huge chunk out of your retirement savings,
but it doesn't have to. With some simple planning, Inflation
can go from being a major disruption to just a

(18:24):
minor annoyance.

Speaker 4 (18:26):
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Speaker 3 (18:28):
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Speaker 2 (18:36):
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Speaker 3 (18:40):
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any ownership.

Speaker 6 (18:44):
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and with Jeff Howell and the team at Health Markets
and Lexington, finding that perfect plan is easier than ever,
whether health or medicare insurance, let the experts guide you
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(19:04):
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Speaker 4 (19:08):
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Speaker 6 (19:09):
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(19:32):
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Speaker 1 (20:07):
We had a conversation a few weeks back with Jeff
Howell and still no resolution to all this. This was
the big falling out between that and lection and medical center.
And again some folks who are on Medicare advantage plans
are having to make good changes here because of it.
And we wanted to replay this conversation this morning because
there's a very vital information here, some things you need
to know about that if you find yourself in this situation.

(20:29):
So let's do that now with that. Jeff Howe, our
friend from Health Markets, Jeff.

Speaker 7 (20:33):
Good morning, Good morning Gary.

Speaker 1 (20:35):
So, I guess recently we just found out that there's
a parting of the ways between ATNA and LEX and
medical center. Is that right?

Speaker 7 (20:43):
Unfortunately, that is correct. So this is really the first
time in a very long time as long as I
can remember, that insurance company and a hospital have part
of ways. After the Medicare annual and ROMA ended you
know October fifteenth, December seventh is an annual enrollment when

(21:05):
people on Medicare can choose their Medicare advantage plan for
the next year. And during that time, of course, we
had we had assurances from ETNA and Lexa Medical Center
frankly that at the Medicare advantage was not part of
the contract negotiations. We had heard rumblings that the group

(21:27):
side or the commercial side, if they were, that they
were negotiating at the February first contract, they didn't know
if at the group Health would still be a network
on February one, but they said no problem with the
Medicare advantage side, no worries on the Medicare advantage side,
and lo and behold. On December eleventh, that changed, and

(21:50):
letters went out and posts were made on people's my
chart account who have lex and Medical Center as their
doctors that at the Medicare advantage may not be in
network come February first, and so essentially it might be
time to start looking for other plan options. So, which
is a shot to all of us, frankly.

Speaker 1 (22:10):
So you've got you've got customers and folks you know,
all across this area had had taken advantage of the
EDNA on the advantage plan, only to find out then
after the fact that yet No, hah.

Speaker 7 (22:22):
That's correct. And that was very disappointing, I must say,
because luckily we're not taping this on December eleventh. You
probably would not, I would not have been a very
good mood since, but I certainly was. I was. I
was not very happy with my ETNA representatives who had
assured me that Medicare was not not in play in

(22:44):
these contract negotiations, because you know, what I told them,
and the way I feel is that you know, senior
citizens and you know, of course, especially in our community
who we care about here in Lexing County, they should
not be used as palms and negotiations, and that's exactly
what's being and that's exactly how they're being used, you know.

(23:04):
So from you know, taking Medical Center's word, what they're
what they told me, and what was actually in writing
is that at the eleventh hour, you know, or essentially
you're right after open ROLLMA ended around December tenth, past midnight,
right past midnight, at a pulled pulled the Medicare advantage

(23:26):
from Lexington or they essentially reduced their fees so much
they included the Medicare advantage as part of the negotiations.
Essentially saying, okay, if you want to sign a if
you want to agree to our fees on the group
commercial side, then we're going to reduce our fees on
the Medicare advantage side so much that you're going to
lose the Medicare advantage.

Speaker 1 (23:45):
Okay, So this is a bargaining chap, yeah, because that
was the original rub was the commercial.

Speaker 7 (23:50):
Side, right and correct. So that's very disappointing, very disappointing.
But luckily there is a law and that's called the
open Enrollment which lasts between January one to March thirty one,
which which actually you know this this situation was in
mind as other situations, so a person on a Medicare

(24:11):
advantage plan can make a one time change. So my
January is getting booked up with all my clients because
I've already told them, let's go ahead and get on
the calendar in January and if this, if this contract
does not get resolved, then we're going to we're going
to make a change for February first. So luckily ATNA
is still in network with lex and Medical Centers until

(24:33):
February first, so everyone who has it at a Medicare
advantage plan, they're going to be in network in January.
But if we need to make a change to someone
that is in network, which is if we've cross Blue
Shield of South Carolina, then we'll do so on February one,
and and that's then we'll pay that price for what's happened.

Speaker 1 (24:53):
So, so what is your what's your thought on this, Jeff? Now,
if if this were me and you know, I had
signed up for Medicare and vantage with that nah, and
I come to find out this news and I come
sit down with you next month, and you say, well, okay,
now Edna's back in. You can still make the change.

Speaker 7 (25:11):
Or not, you can still make the change.

Speaker 1 (25:13):
Most people would, right, they're going to be ticked off
enough to say, well, the heck with you, ed Now,
I'm going somewhere else.

Speaker 7 (25:18):
That may just happen. Now if you can pick a day,
but before I meet with let's say that I'm meeting
with a client on January thirty first, right, and before
that day at an elected medical center, made an agreement.
You know, what we do is what we always do
with our clients. We'll look at the doctors, we'll look
at the prescriptions, we'll look at the benefits, and we'll

(25:41):
put I'll put my client on the best plan for them.
But if a client, but let's say two companies are equals,
let's say is equal to company Company B in almost
every way, then if a client says, I'm done with that,
and then well I can't hold them against them are
making that decision frankly right now?

Speaker 2 (26:02):
Huh huh.

Speaker 1 (26:03):
Well, there's been a rash of these recently. It seems
like this is like the third one in the last
maybe year or less.

Speaker 7 (26:09):
That's true. You know, we still have Humanita and MUSC
not a network, so that never got resolved, and then
last year it was prismon United Healthcare, which got resolved
on April one, twenty twenty four. But as we talked
about in the past, these are getting unfortunately more and
more common. As these national for profit insurance companies they're

(26:34):
beholden to their shareholders right to make as much profit
as possible so their stock goes up. They want to
pay these our hospitals, our local hospitals here in the
Midlands as little as possible, and so in these hospitals
don't have much leverage or much tools to fight back
with other than saying, well you just want to be

(26:55):
in network with our hospital.

Speaker 1 (26:56):
So how popular is the plan here? I mean, I
would I'm just guessing here that maybe the Blue Cross
Blue Shield when it comes to the advantage plan is
maybe the most popular on this area.

Speaker 7 (27:10):
I would say there's I would say there's four in
this area that are very popular, and almost equally so
United Healthcare Humana at non Blue Cross and has a
very large market share in Luxin County, very very large.
And so there are many people I'm sure listening to
the show who have at the Medicare Advantage ID card

(27:30):
in their pocket. And so it's it's very disappointing that
this would happen after December seventh. I certainly didn't see
it coming, and you know, the rumbling on the commercial
side concerned me. But when I get assurances from all
parties and writing that Medicare advantage is not part of
the negotiation, you know, it really puts egg on on

(27:55):
certainly a lot of people's faces, and it's very disappointing.

Speaker 1 (27:58):
Right, absolutely, just curious now because you mentioned that. So,
but this does allow folks between January one and I
think you said March thirty one to make a one
time has a one time change for this calendar year.

Speaker 7 (28:10):
Correct, not, that's just twenty five okay, correct?

Speaker 1 (28:13):
If you blowed chest to make any more changes, Okay,
just listen, what would have happened or could this have happened?
Would have had to come down April one and said
we're pulling out, what would happen?

Speaker 2 (28:23):
Then?

Speaker 7 (28:25):
Yes, that would have been. That would have probably been.
That's probably the worst case scenario because that at that
point in time, a person has no really I guess
way to make a change from one carrier to another carrier.
We would have to maybe you know, talk to Medicare

(28:46):
and see if any special exception would be allowed under
that circumstance. I've never seen that happen. However, I've never
seen that happen on December eleventh before. Yeah, so I
can I I would I would say in the past, oh,
that's not possible, But now I can't say that because
now it seems like anything is possible.

Speaker 1 (29:06):
You know, I'm never one to uh to ask for
you know, government intervention as much of anything, but it
would seem like there ought to be some kind of
a law that would approved that would prohibit an insurance
company from pulling the stunt like that. After that, you know,
grace period is over all.

Speaker 7 (29:20):
Right, and that's something you know. I work with a
group of insurance professionals. We go to Washington every every February,
and this is definitely going to be a top of
the list, these these contract negotiations and these changes, and
how how our clients are being used as pollings these negotiations,
and how something definitely needs to be done.

Speaker 1 (29:41):
Absolutely Okay, So again to recap, if you're holding a
net in a card and you're you're in network at
election in the medical center, you won't be after what
in the January correct February one as a February one.

Speaker 2 (29:54):
And.

Speaker 1 (29:56):
Again, Uh, what you hope is that somebody's not sitting
out there not aware of this. Do they get notification
from ETNA or election to medical center lect and.

Speaker 7 (30:05):
Medical Center has been very good about notifying its clients.
They they posted it on their my chart in the
morning of December eleventh, and then letters went out right
after that. So patients should have either one or two ways,
either read it on their my chart computer or their
app on their phone, or received a letter in the mail.

Speaker 1 (30:24):
Well, you know there's gonna be somebody out there who
just totally misses all that, right, and they're going to
get a rude awakening.

Speaker 7 (30:31):
That's true, that's true, but it's well, we try to
get the word out as much as we can, certainly,
and talk to our clients and you know it, and
it may get resolved, it may not, but either way
we want to We want our clients to be prepared,
and certainly we welcome people who are not our clients.
We'd be happy to meet with you in January and

(30:51):
look at all the options.

Speaker 1 (30:53):
You know.

Speaker 7 (30:54):
It's it's disappointing that is happening, but well, we'll do
the best we can to help and help with many people.

Speaker 1 (31:00):
We can, certainly, And of course that's always free, right, Yes.

Speaker 5 (31:03):
My.

Speaker 7 (31:05):
Services are free, so do not cost anything, and I'm
glad to help.

Speaker 1 (31:09):
Do you recall another time in the span of less
of a year that we've had not one or two,
but three different situations like this?

Speaker 7 (31:16):
No, no, this is very unusual, for sure, and I
hope it's not a trend for the future.

Speaker 1 (31:21):
Yeah right, okay, Well, something else going on and although
help me understand this. So the open marketplace enrollment period
ENDO December fifteenth, but not really or.

Speaker 7 (31:34):
That's a good point. So it's interesting how they do
the commercials with Healthcare dot Go. They push everyone. They
extended it actually to December eighteenth, but eventually the commercials
were pushing people to December fifteenth, which is a Sunday,
and then because it fell on a Sunday, they extended
the open AROLLMA for January first coverage to December eighteenth.

(31:57):
And of course, now we're talking about people under sixty five,
people who are on the individual marketplace for individual health insurance. However,
that is not the deadline. So the true deadline is
January fifteen.

Speaker 1 (32:11):
January fifteenth, okay.

Speaker 7 (32:12):
So anyone who would gets the policy between December nineteenth
and January fifteenth will have a February first effective date.
So okay, like anything in life, health care, I got
knows that action. You know, deadlines breed action, right, So
they're pushing everyone to the first deadline, then the second

(32:33):
deadline December eighteenth, and now you'll see commercials and radio
ads pushing everyone to get enrolled by January fifteenth, which
is the true drop dead deadline.

Speaker 1 (32:44):
Okay. Yeah, Now, of course you have options here, I
mean you can go on the government website. But again
keep in mind it's a government website. They're not always
the easiest to navigate.

Speaker 7 (32:59):
It is probably the trickiest website I've ever been on
them that it is very tricky. And I have many
clients that have come to me and they have been
on there, and they've tried and tried, and they put
all their information in time and time again, and keep
getting a thousand dollars a month premiums. And they come
to me and I show them a premium of one

(33:21):
hundred and fifty dollars. You know, it's just because it's
tricky how how the subsidies are applied, and how what
questions you have to answer exactly the right way to
get the subsidies at a person or their family. Absolutely so.

Speaker 1 (33:35):
In other words, even even if you were to charge
somebody in this instance, you know, eight hundred and fifty
dollars for your expert advice, they'd pay that off in
a month.

Speaker 7 (33:46):
I wouldn't do that.

Speaker 1 (33:47):
But you know, you don't charge them. You don't truge
folks anything. It's absolutely free.

Speaker 7 (33:51):
But yeah, yeah, I appreciate the analogy, but yeah, my
services are free. But yeah, I think it's just it's
the way the website's written and the questions they ask
are not defined well. And so you know, if someone's asked,
for example, you know, are you offered an HR? Well,
you know these acronyms. People people don't know what they

(34:12):
mean to ask you what that meant?

Speaker 1 (34:13):
I have no idea, right and.

Speaker 7 (34:15):
So exactly, so you answer yes to the wrong question
and your subsidy is knocked out, and then you know
you've got you've got this gigantic price staring you in
the face, and you have no idea what to do.
So I'm always glad to help people with with healthcare
dot go and get them individual health insurance. Absolutely.

Speaker 1 (34:33):
Now, just a quick question here before we wrap things up.
Let's say we're in a situation someone has maybe a
spouse who is working and has coverage to their employer.
But you know, you start adding on, you know, family
members and stuff. It gets a little outrageous. Can that
Can that spouse who's not employed go on the open marketplace?

(34:56):
Or or are they or is that going to be so? No, No,
I'm sorry, your spouse has covered their employee. Gotta go
with that.

Speaker 7 (35:03):
Luckily, that law changed in twenty twenty three, so it
used to be the old way that if one person
was offered group health insurance, that essentially knocked the whole
family out of subsidies, which makes the health insurance affordable
in the individual marketplace. But starting January one to twenty three,
now only employees essentially, now only the employee has to

(35:25):
stay with their group health plan, and spouse and dependents
can now shop the open marketplace and get subsidies and
get affordable health insurance.

Speaker 1 (35:33):
Okay, okay, And what I mean, what's the average? And
I always hate asking this question because it's so many
variables involved, I know, but I mean, the average subsidy
for the average person, you know, gets this this coverage
down to about what range in any given month.

Speaker 7 (35:48):
I mean, yeah, yeah, you're right there. There are so
many variables, but essentially i'd say the average customer mine
pays around two hundred dollars a month for their health
insurance if I had to to average on it.

Speaker 1 (36:01):
And we certainly know that if you've ever covered a
spouse on your employee health plan, is going to be
probably a lot more than that.

Speaker 7 (36:08):
Yes, usually it is absolutely.

Speaker 1 (36:11):
Okay, so does January fifteenth deadline for that? So keep
that in mind. And again, as we started talking about originally,
if you're on Medicare advantage and ATNA, then they call
this guy right here and go over and sit down
and talk to him by the end of January, certainly
before then, to see what your options are.

Speaker 7 (36:31):
That's right, we'll be here. Our office is right beside
the flight deck restaurant Health Markets and Glad to take
walk ins and clad to set appointments and help people
and make sure they're not left out in the cold
after February first.

Speaker 1 (36:45):
All right, so eight three six seven eight eight one
two one right six seven eight eighty one one. And
your website is your name? Right?

Speaker 7 (36:54):
Yes, www dot j E F F h owl e
dot com.

Speaker 1 (36:58):
All right, Jeff, thanks so much, buddy.

Speaker 6 (37:00):
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and with Jeff Howell and the team at health Markets
in Lexington, finding that perfect plan is easier than ever,
whether health or Medicare insurance. Let the experts guide you
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(37:21):
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Speaker 4 (37:26):
Best of all, their help is at no cost to you.

Speaker 6 (37:29):
They work with nationally recognized insurance companies to give you
the affordable insurance you're looking for. So whether you're self
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(37:53):
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and let them find the right insurance for you.

Speaker 8 (38:01):
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a certified mold inspector. We can help you test the
air in your home ten minutes per sample, one sample inside,
one sample outside. If we do it in the morning,
we'll have the lab report that afternoon, and then we
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(38:23):
to clean the air in your home. Particularly if you
have coughing, sneezing rashes on your body. This could be
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(38:44):
have any airborne issues in your home. This is Larry
Harris with Classic Systems eight three six two six two
seven four eight eight three six two six two seven
four eight.

Speaker 1 (39:27):
Welcome back to the Health and Wellness Show, and thanks
for joining us this morning here on one O three
point five FM and five sixty A m w b OC.
As we now welcome into our final segment of the
show this morning, Jim Snell from the law office of
James Smell the James Spell.

Speaker 2 (39:40):
Listen to me, James Snell, Morrin, Sir Garrett, I tell
you what you were always you were always outstanding. But
I tell you what I really appreciate you this morning,
and I'm sure your listeners do. You saved the best
for last well dog all right right, finishing out with
a bag.

Speaker 1 (39:55):
Yes, how you been? Brother?

Speaker 2 (39:57):
Oh? I tell you te you know. I think since
I was up here last time, I went to Greece.
You went to Greece. I went to Greece. One of
my former associates got married invited me to the destination wedding. Huh.
It was a It was the big fat Greek wedding
in Greece, and it was as as just like the movie. Yes, wow,

(40:18):
so yeah, yeah, so you saw all the sites while.

Speaker 1 (40:20):
You were there?

Speaker 2 (40:21):
I did, Yes, Yes, I saw the Cropolis, which is
the hill kind of the mountain, and then the Parthenon
on top, and yeah, have great time. After after flying
trans Atlantic and dealing with all that, we get to
the hotel. We had a couple hours before the room
was ready, and I had a couple like I had

(40:42):
a bag of stuff I didn't want to leave with
the hotel and so carrying that after flying trans Atlantic
for a couple hours, been down hills. Oh you know,
I'm glad to get anyways, but it was great.

Speaker 1 (40:54):
So, you know, for a trip to Greece, I'll try it.

Speaker 2 (40:57):
Yeah, No, it's great. So everything deserve that. I recommend
Greece's put that on the bucket list. Yes, my bucket
list is a little is overflowing right now. That's a
good problem. That's a good problem.

Speaker 1 (41:08):
Well, the problem is trying to afford clearing it out.

Speaker 2 (41:12):
Well, I was gonna say, but you know, be awful
to get to the point where you feel like you've
done everything. There's true there's nothing else I want to do.

Speaker 1 (41:18):
I'm just done with life. I'm checking out. Yes, yeah,
we want to talk about contingencies as well as back
on the personal injury cases. And I guess let's start
with this, Jim, let's couldn't find Let's define that as contingencies.
What are we talking about? All right?

Speaker 7 (41:35):
So?

Speaker 1 (41:36):
Okay?

Speaker 2 (41:37):
So, so in my office we represent people who have
been injured in accidents or had family members you know
who were you know, children who were injured, or family
members who actually you know, could have died in accidents.
Whether whether these are work accidents, car accidents, kind of

(42:00):
slipping falls, are just other circumstances where there could be liability, right,
And obviously work accidents doesn't matter how you got hurt
as long as those at work. Other type of accidents
typically it's got to be somebody else's fault.

Speaker 1 (42:21):
Right. Let me back up every seconds, So on a
work accident, workman's comp case doesn't matter how it happened.

Speaker 2 (42:27):
As long as it was at work, are in furtherance
of basically work purposes.

Speaker 1 (42:33):
So I'm I'm doing something for my job, but I'm
negligent in my approach to it, and I wound up
getting hurt. It doesn't matter, it doesn't matter, it doesn't matter.

Speaker 2 (42:42):
Benefits are the same, okay, all right, that's when the
trade offs, right, workers' comp is is is a little different.
The benefits are guaranteed, but they're a little different. Right,
So that's one of the trade offs. Okay, And all right.
So so those are the kind of cases and in
these situations we when we sign cases or we take

(43:04):
on cases, we don't require our clients to pay any
money upfront. Okay, So people come in. There are a
lot of times people are like, well, how much we
have to pay you for this? And it's like nothing.
Is that always the case at my office when we
take an injury case? Yes, I mean I'm not.

Speaker 1 (43:20):
But that's not necessarily universal.

Speaker 6 (43:23):
You know.

Speaker 2 (43:23):
I think I think most you know, certainly all the
advertising lawyers you see, you know, running billboards and TV commercials.
I mean, I think it's all pretty pretty standard on
personal injury type work. I mean, there there could be certainly,
there could be situations where you know, people may negotiate
in a specific situation, they may negotiate some other different structure,
but you know, fee structure. But generally, if it's going

(43:46):
to be a type of injury case where there's going
to be insurance or you know, resources that could pay.
On the other side, almost every situation I'm aware of
is is contingency. Okay, so no the upfront, no money
up front, and I will tell you that. And what
that means is that in the event we sign a

(44:09):
case and for any reason it doesn't pan out, or
it's not successful, or there's not an actual recovery, you know,
we don't get paid, so we don't We don't go
back to the client or somebody and say, hey, you
os money. Other part of this is when once we
sign a case, there frequently are i'm gonna say expenses.

(44:34):
Just like if you get a mechanic to fix your
car their parts, We lawyers have expenses in the same way.
And I'm not talking general office expenses like you know
your phone bill. No, no, no, but but things like
when when people say they get in a car wreck,
they're taking my ambulance to the emergency room. Then they

(44:54):
have follow up with an orthopedic, they go to the
radiology office, they get an MRI I. All those places
produce records which are necessary to get to have the
case evaluated. And they all charge for them.

Speaker 1 (45:08):
Right.

Speaker 2 (45:09):
And then a lot of times we have to get
an expert to look at records and offer an opinion
on you know, our client's future prognosis or how it's
gonna affect them going forward. Maybe they might need a
future surgery later. How much is that gonna cost? And
you got to pay people to get all these opinions.

Speaker 6 (45:26):
Right.

Speaker 2 (45:27):
So, so in a lot of car case, especially the
more significant cases, that there isn't an outlay of money
that you know is required to pursue the case. Right,
So when we sign cases on contingency, you know we're
advancing or putting those monies into the case. And I'll

(45:48):
tell you in a run of the mill case, you know,
I say we're in the mill, just something pretty straightforward.
You know, those might only end up being a few
hundred dollars. In real significance. More catastrophic cases, you know,
it could end up being several tens of thousands. Right,

(46:11):
And again, those aren't amounts we expect the client to
pay up front. We would pay them and then same
thing if for any reason the case isn't successful in
an actual recovery being attained. You know, we don't ever
look back to the client to reimburse their pay So
you're eating those costs if it's not successful, eat this cost.
And one thing I'm contingency fees, you know, And again

(46:36):
lawyers charge different fees, right, So I don't want to
get too specific here, but but there are a range
of fees. Not every lawyer charges the same contingency fees,
so the percentage can vary, right, and there are a
lot that have kind of crept up the the amount.
One thing I will say though, specifically, is in a

(46:57):
field like medical malpractice, where you do have a higher
percent of cases result in no recovery, right, because it's
difficult to you know, doctors, you know, medical issues can
be difficult.

Speaker 1 (47:13):
And they're probably more expensive cases.

Speaker 2 (47:15):
And there were expensive to bring and uh. In in
that world, you know, pretty well, forty percent contingency seems
kind of standard in everything else it it generally can
be a lower percentage, right, But but again feeser can
be different per lawyer, per law firm, and people should
always I've heard thirty is kind of a third. The

(47:39):
third third was considered standard, although again you've you've seen
some different I have. I am aware now that there
are some law firms, especially some the heavy advertising that
that may be working off a different model. So people
should just be aware because that's yeah higher right, yeah,
and you know, but I mean, you know, if you're
you know, you're running you know, if you're spending millions

(48:02):
you know for TV spots and advertising a year, you know,
it's it's a it's expensive. You know, they have overhead.
I mean, i'll call it, right. So, but that's the
contingency few model and so people that's one thing people ask.
So when when when people reach out to us, Right,
One of the things happens is my office. You know,

(48:24):
we have actual h employees who screen cases. You know,
they don't I mean, we have an after hours call
center and all that, but but the actual you know,
work in the office and the screening the cases is
done by you know, my employees sitting in Lexington, South Carolina,
you know, you know, and they start out by asking
some questions to make sure that there's a potential bonifid case.

(48:48):
You know, when did this happen?

Speaker 1 (48:50):
Right?

Speaker 2 (48:51):
We want to make sure that the situation or accident
was recent enough that it's still within the statue limitations.
Easually three years could be a little shorter. We want
to make sure that there actually was an accident that
was somebody else's fault. Right, We'll make sure there were
there was an actual injury.

Speaker 1 (49:12):
Right.

Speaker 2 (49:12):
You know, people do call lawyers with all the time
with kind of situations that may be unfortunate or maybe
something unusual happened or something scary happened.

Speaker 1 (49:25):
You get you got your feelings hurt.

Speaker 2 (49:27):
Yeah, I know it happens, right, and and and so
you know, and obviously we're sympathetic to those situations, but
there aren't they aren't things that we can turn into
legal issue, right. I'd love to be able to figure
out how to how to get insurance settlements whenever somebody
was rude to somebody else, right, But I ain't figured
that out yet. So so anyway, ask a few questions,
when did it happen, what happened? Were there actually you know,

(49:50):
was there actually injuries? Right? And then you know, and
then you know, pretty pretty low stressed, you know, kind
of easy conversation, just a dialogue. And then once once
you know, our office kind of determines that you know, this, hey,
this could be something meritorious because we're also not looking
to sign up any frivolous you know, yeah, we'll set

(50:10):
them up to meet with me or another lawyer, and
you know, that's when we talk kind of in depth
about what happened, what the issues are, what the damages are, like,
how hurt are they? Uh, you know, what are the
medical bills, what's the pain and suffering, what's the lost wages,
that sort of thing. And then at that point, if

(50:30):
everyone agrees, you know, we can we can agree to
take on the case where we do a written engage
in agreement stating exactly what the fees are, how they're
computed to no surprises, you know, and and that's when
we can start work.

Speaker 1 (50:45):
And you should expect that any attorney you've talked to
in a case like this, you you you should expect
upfront to know, okay, here absolutely know that are expenses
that that that that are incurred then that's coming out
of that on top of those fees. Yes, I would
hope that nobody is ever surprised at the end of

(51:06):
a case. Wait what.

Speaker 5 (51:08):
You know?

Speaker 1 (51:09):
So well?

Speaker 2 (51:09):
Okay, so so obviously you know whenever whenever and I'll
tell you, you know, whenever you talk about money, right,
people that people always you can have weird we you know,
sort of sort of it could bring out some of
not the best in people, right, but but money has
a way of doing it. So yeah, but but and
that was I hear stories from from people that had

(51:30):
other lawyers. I hear stories from other lawyers. And what
you do is you uh to really nip that stuff
in the bud. You do written engage in agreements. You
clearly state what the fees are, how they're computed. As
the case goes on, is working, you know, you periodically
make sure you check in with the client, let them
know kind of what the expenses are, like Like for example,

(51:52):
if we're hiring a like a consultant to offer recommindation
on future medicals, you know, we want to know what
that cost is. Let your quite know before we spend it,
just as the new surprises. Absolutely all right, here's all
I know. Anybody that thinks we might be to help them,
We're we're at eight zero three three five nine three

(52:14):
three zero one. Are they visitors online at Snell law
dot com. That's three yels Snell law dot com. We're
here to help anybody with their injury or workers' compcases,
all right, and.

Speaker 1 (52:24):
We are out of time, my friend, have yourself a
great weekend, buddy. The lawyers and staff at the Law
Office of James Snell are there to help those with
injuries and workers' compensation claims, car accidents on the job,
and other accidents resulting in injuries. They want to help
everyone resolve their claim as quickly as possible, but they'll
never recommend you accept a settlement that's unfairly low. The

(52:47):
Law Office of James Snell recognized by AVA with a
ten and an eight plus reading with a better Business Bureau.
There's no cost to speak to them. Insurance companies make
their money by denying and minimizing otherwise valid claims. The
Law Office of Jameis Snell can help. They're not looking
to try to take every small mishap, but focus on
real injuries that deserve to be taken seriously. The Law

(53:07):
Office of James Snell. I'm Jim Snell. Contact me at
Snell Law dot com. That's three ls Snell Law dot com.
The Law Office of James Snell since two thousand and four,
with offices in Lexington and Columbia.