As consumers shop for coverage on the exchanges, knowing the trade-off between premium price and network size could be important to some, says Kathy Hempstead, director of the coverage team at the Robert Wood Johnson Foundation, which funded the study.

“People don’t have a good way to understand what they’re buying,” Hempstead says. “I think we need to frontload more consumer information, and what your network is like is important.”

Plan type isn’t a good indicator of network size, according to the study by researchers at the University of Pennsylvania’s Leonard David Institute of Health Economics. Eighty percent of the plans offered on the marketplaces were either preferred provider organizations or health maintenance organizations. Yet even though HMOs typically don’t cover any out-of-network providers, more than half of HMO physician networks were either small or very small. By contrast, only a quarter of PPOs, which typically cover providers who are outside the plan’s network, had physician networks that were classified as either small or very small.

Under the health law, health plans have to “maintain a network that is sufficient in number and types of providers … to assure that all services will be accessible to enrollees without unreasonable delay.”

Previously, the consulting firm McKinsey & Co. analyzed narrow networks based on the proportion of hospitals that participated in a plan’s service area. This is the first study to examine physician participation in exchange plan networks, Hempstead says.

“If you’re going to be in a direct-to-consumer market you have to be ready for these issues,” she says.

Article Source: Kaiser Health News

Sonoma Valley Insurance Agency can help answer your questions about health insurance and health insurance. 

Please visit our website or contact John Caris at 707-935-6294 x103 or email him at jcaris@carisagency.com.

The results surprised researchers – particularly as insurance issues surrounding self-driving cars are decidedly thorny.

“When, if ever, will a faultless driver be ‘legally responsible’ for an accident or be ‘legally entitled’ to recover from a faultless, uninsured motorist?” said Robert Peterson, director of the Center for Insurance Law and Regulation at Santa Clara University. “If [the primary responsibility] is on the operator, will it be passed to the manufacturer? How will all of this impact premiums for insurers?”

Peterson is also interested in the clash between state law in California—the largest insurance market in the US—and the practicalities of self-driving cars.

“California operates its private automobile insurance market under Proposition 103. This law imposes some mandatory rating factors, such as driving record and the “good driver discount” that make little sense when the cars drive themselves,” Peterson told Insurance Business. “Also, it is awkward to adjust rates as risks rapidly change with improvements to programming, mapping, etc.”

These and other complications will make it difficult for insurers to adequately base auto rates when the cars are initially introduced. However, many insurance companies are already considering offering discounts for drivers who purchase semi-autonomous vehicles.

In Europe, for example, customers who purchase a new Volvo with pedestrian protection technology qualify for lower premiums as the cost of pedestrian accidents to insurance companies is significant.

Those discounts are already spreading to the US, and will likely slash the estimated $800 Americans spend on car insurance each year to a significant degree.

After all, as David Carlisle of the auto industry consultancy Carlisle & Company says – “If the car can’t wreck anymore, those premiums have got to go down drastically.” 

Article Source: Insurance Business America

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Check out the contractor

As you would with any major remodeling or renovation project, do your homework and talk to more than one solar installation contractor if you can. Try to get references from others whose properties are similar to yours so you have a basis of comparison for the work. Confirm whether your local zoning laws require permits or variances; the contractor should be responsible for obtaining these for you.

To work correctly, the federal Energy Department says, your solar electric system or photovoltaic (PV) system needs to be sized, sited, installed, and maintained correctly. Make sure your contractor is properly licensed or certified to work with PV systems, and check to see how many years of experience the company has. Ask whether the contractor also insures any subcontractors on the job and whether all the employees are covered by workers comp. Agree on the condition of the premises before the contractor starts work so if damage occurs, you won’t find the installer claiming that your roof was already in need of repair before the workers arrived.

What about warranties?

It’s also important to find out what kind of warranties are available for the work and for the equipment itself. You may purchase the best equipment available but if it isn’t installed correctly, you won’t reap the benefit.

According to SolarEnergy.net, a website dedicated to news and information about solar energy, “the key to understanding the warranty on your solar power system is considering each component separately, as well as recognizing that the installer’s work is also a separate matter.” The typical parts and labor warranty covers two years, in addition to the regular manufacturer warranties on the individual solar components. A name brand solar panel will have a 20- to 25-year warranty on the power output.

Will my homeowners policy premium go up?

Although insurance carriers vary in the way they account for solar panels in calculating premiums, most have some kind of coverage in place. However, you should talk to your agent to determine whether adding solar panels will increase your premiums or make you eligible for a discount. You and your agent should consider:

• Is the solar energy system likely to suffer damage from tree branches or other objects striking the panels?
• Are lightning strikes, fire or high winds a potential hazard? How about hail, snow or torrential rains?
• Is the system likely to be vandalized or have parts stolen?
• Will your current carrier continue to insure your property or do you need specialized insurance?

You may also be eligible for energy tax credits from your state or local government as well as on your federal taxes. If you’re thinking about going green and switching to solar – let the sun shine!

Article Source : Property Casualty 360

If you have solar panels on your roof, be sure to check with us to ensure that your homeowners insurance will adequately cover the extra expense in event of damage.  

For more information, call John Caris at 707-935-6294 x103

Transportation Network Companies like Uber, Lyft and Sidecar should bear the insurance burden when they encourage drivers to use their personal vehicles to transport passengers for a profit, according to recommendations made Wednesday from California Insurance Commissioner Dave Jones.

Jones’ recommendations were made to the California Public Utilities Commission, which oversees TNCs in California. His recommendations stem from a recent Department of Insurance investigative hearing in which insurers and TNC operators squared off over how auto insurance should be handled.

Jones’ recommendations were greeted with enthusiasm from insurer groups like the Property Casualty Insurers Association of America, which has been pushing for TNCs to provide primary commercial coverage for their drivers and not rely on personal auto insurance.

“It’s very good. I think he came down on the side of what is right, and what is safe for consumers and for drivers,” said Nicole Mahrt Ganley, a spokeswoman for PCI. “I think that he’s being responsible.”


TNCs have become a high profile topic in the last few months, and even former San Francisco Mayor Willie Brown has joined the debate. The TNC issue has gained public attention in part thanks to a perceived gap in insurance coverage, and a New Year’s Even incident during which a TNC driver under contract with Uber struck and killed 6-year-old Sofia Liu. Her family has filed a lawsuit against Uber. Uber issued a statement saying the driver, 57-year-old Syed Muzzafar, was not responding to a fare and didn’t have a passenger in his car when he struck Liu.

Since then the debate over TNCs has grown. The sticking point in the debate, which has taken on a triangular battle between TNCs, the insurance industry and taxi and limo providers, has been over a gap in insurance coverage during the period when TNC drivers have their smartphone app on but have not been matched with a ride.

“Our position has been that when the app is on and until the app is off the TNCs should provide their drivers with coverage and the personal auto policy should not be on the hook for that,” Ganley said.

In arguing that TNCs should provide commercial coverage, insurers noted that most personal auto policies have livery exclusions that will deny coverage if a person is carrying a passenger for hire.

In a statement announcing his recommendations Jones called attention to those gaps in insurance during TNC actives, and said: “As long as TNCs are encouraging non-professional drivers to use their personal vehicles to drive passengers for a profit, a risk which personal automobile insurance simply does not cover, TNCs should bear the burden of making sure that insurance is provided. Our recommendations will ensure there is insurance protection for passengers, drivers and pedestrians.”

TNCs were already required to have a $1 million commercial policy on drivers when giving rides or going to pick up a ride, but it was assumed that during this gap that TNC drivers’ personal policies would be in effect.

Jones has already recommended TNCs be required to carry insurance to cover this gap, and large players in the market like Uber and Lyft have already purchased excess commercial policies to cover this period.

However, among Jones’ recommendations on Wednesday was that TNCs be required provide $1 million commercial liability insurance as the primary policy for drivers.

Chris Shultz, a California deputy insurance commissioner, told Insurance Journal the policies held by Uber and Lyft would not be sufficient under Jones’ latest recommendation.

“Their coverage is excess, not primary,” Shultz said. “Our recommendation is that it be primary.”

The excess policy presumes a TNC driver’s insurance is in the first position, and the excess is in second position, he said, adding that in such a scenario, “every fender-bender is going to turn into a coverage dispute between the personal auto insurer and the commercial insurance for the TNC.”

Sultz said the other option to ensure coverage would be to require each TNC driver to purchase a commercial policy ranging from $5,000 to $10,000, which wouldn’t be feasible or available.

“We don’t’ think that you can buy commercial insurance that covers livery use on a personal vehicle,” Shultz said. “There isn’t yet a product that offers a personal endorsement or a rider that covers this use.”

While there had been talk that such insurance products may be in the works, no one has filed with the department to offer anything like what would be needed to cover TNC drivers using their personal vehicles for hire, he said.

Jones’ list of recommendations include:

• Requiring TNCs to provide $1 million commercial liability insurance that begins the moment a driver switches on the app;
• Requiring TNCs to provide $1 million uninsured/underinsured coverage to protect the driver and passenger;
• Requiring TNCs to provide insurance policy information to TNC drivers to carry in their cars;
• Requiring TNCs to disclose to drivers that their personal auto insurance coverages may not apply while they drive for the TNC;
• Requiring TNCs to provide comprehensive and collision coverage for the driver’s auto if the driver has those coverages on the driver’s own policy;
• Legislature should revisit the ridesharing and casual carpooling laws to allow for apps that match not-for-profit drivers with casual riders.

There are three bills pending in the state Legislature dealing with some aspect of TNC operations, and Shultz said he believes it’s likely that one of the authors of those bills may decide to include language in the bill make it so that TNC drivers’ personal auto insurance doesn’t get canceled or non-renewed by their personal auto insurer.

“We’re seeing where companies have canceled drivers after people have told them they are doing TNC services,” he said.

Lyft and Sidecard spokespersons didn’t immediately respond to requests for comment for this article.

Uber spokesman Lane Kasselman provided this written response, as well as the hyperlinks, via email:

“Uber’s ridesharing insurance policies lead the industry and ensure safety and coverage for riders and drivers. On top of the $1million commercial policy during trips, Uber was the first to add $1million of uninsured/underinsured motorists’ coverage during trips and to put contingent coverage in place to cover the time that a driver is available to receive requests but between trips.  As a recipient of a TNC permit from the California PUC, having clearly met all CPUC requirements, we are proud to be the standard-bearer on this issue.”

Kasselman did not respond to follow up questions regarding Uber’s contingent, or excess, coverage.

Geoff Mathieux, founder of Wingz, a planned rideshare provider that focuses on trips to the airport, was encouraged by Jones’ recommendation that the Legislature revisit laws pertaining to ridesharing, but thinks any such law should pertain to for-profit activities.

He’d like to see the Legislature create laws that enable drivers to purchase optional coverage for their for-profit ridesharing activities, particularly since many TNC drivers use multiple ridesharing apps.

“We’re seeking to recommend to the California Legislature to create a law to allow citizens to purchase optional coverage for any paid or for-profit activities they may engage in in their personal vehicles,” Mathieux said.

Mathieux has as his legal representation Willie Brown Jr., San Francisco’s former mayor and former speaker of the Assembly.

Brown, who Mathieux said is a part owner in Wingz, submitted written comments to CPUC to encourage the group to consider creating a legislative vehicle providing for such optional coverage.

“Californians need the option to purchase additional personal insurance for their ridesharing activities, regardless of what method they use to find riders,” Brown wrote. “The requirement for automobile insurance should be on the driver, not on the website company.”

In his comments Brown noted that Craiglist, Meetup.com, 511.org, and various university websites offer similar paid ridesharing matchups but have no commercial insurance.

Mathieux  said a new law from Legislature that enables such coverage would eliminate confusion around which insurance is responsible.

“If you continue a system where we’re the ones who have to have the insurance and there’s accidents, people are going to point the fingers at multiple companies,” Mathieux said. “It’s going to continue the climate of litigations that is currently surrounding this whole thing.”

The commissioner’s letter and complete recommendations to the CPUC can be found on the department’s website. 

Article Source: Insurance Journal

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NEW YORK (MainStreet) — It is one kind of Russian roulette nearly all of us play.

You would not empty a revolver of all but one bullet, spin the cylinder and aim the barrel at your head.

But most of do an equivalent at the rental car counter when the question is popped about whether you want the optional insurance.

Do you need it? Back into a craggy high desert boulder in Taos, NM and, odds are, the costs will top $5,000 to replace the rear bumper and maybe a fender. And that is a trivial accident. Get into something serious and the vehicle will be totaled and now we are talking real money.

But insurance protection bought at the car rental company is not cheap, either.

At Enterprise Rental Car the going rate for CDW (Collision Damage Waiver) bought online when booking is $11 per day. Many other companies charge more. $20 per day is not unheard of.

At least in Phoenix on weekend days, a Chevy Spark can be rented for $33 per day.

That means the insurance is a big piece of the final price.

Should you say no?

"It is common to get a high-pressure sales pitch for CDW at the rental counter," said John Wetmore, producer of "Perils for Pedestrians" television. "Since I know my facts ahead of time, I can turn down the CDW with confidence."

That's because Wetmore believes he is amply covered by his personal car insurance and also by coverage provided by a credit card.

Is he right? Probably because he has looked into what coverage he has.

Article Source: Main Street

For a no obligation insurance quote, call Elissa at 707-935-6294 x 102 or Email your question.

States from New York to California are taking steps to crack down on employers who improperly classify their workers or fail to declare their income. Thirty states have laws on worker misclassification, up from 23 in 2010, according to Construction Citizen, a website that says it seeks to advance social responsibility in the industry.

“There was money to be had,” Linda Donahue, senior extension associate with The Worker Institute at Cornell University in Ithaca, New  York, said in an interview. “The success at identifying those employers  has led to pretty substantial revenue for the states.”

Employment Taxes An employer can save on average $3,710 annually in employment taxes for each worker earning a salary of $43,007, according a June 14 report from the Treasury Inspector General for Tax Administration

“The misclassification of employees as independent contractors is a nationwide problem affecting millions of workers that continues to grow,” according to the report.

To recover lost revenue states must first identify such workers. In May, Connecticut said that after a 12-month audit it had reclassified 3,487 workers and uncovered $68.2 million in unreported payroll representing $1.3 million in lost payroll taxes. In February, a New York state task force said it found 20,200 instances of workers treated as contractors in 2012, representing more than $282.5 million in unreported wages.

Massachusetts identified 5,491 misclassified workers last year, according to Lauren Jones, a spokeswoman for the state Department of Unemployment Assistance. That contributed to $46 million in unreported wages.

Drains Revenue “It is fraud plain and simple that drains governments at every level of much needed revenue,” Sarah Leberstein, a staff attorney with National Employment Law Project in New York, said in an interview.

Investigations at the state level back up the latest national audits, which suggest the problem is worsening. A Department of Labor study of nine states in 2000 found that up to one third of employers misclassified workers. In 1984, an Internal Revenue Service report put the figure at 15 percent, leading to 3.4 million misclassified workers and a $1.6 billion revenue loss. The agency is in the process of updating its estimates.

“There’s just a general increase in lawlessness among employers,” Ross Eisenbrey, vice president of the Economic Policy Institute, a Washington-based non-profit group affiliated with organized labor.

In Tennessee, the growth of the construction industry led to worsening wages and unregulated workplace arrangements, according to a 2010 report co-authored by William Canak, professor of sociology at Middle Tennessee State University.

Tennessee Losses Using U.S. Labor Department data, the report found that 9,098 construction workers in Tennessee were misclassified in 2006, leading to losses in unemployment insurance payments of up to $14.9 million and missed workers compensation premiums of as much as $91.6 million.

In addition, federal income tax loss for 2007 filings was high as $73.4 million while Social Security and Medicare losses ranged from $7.8 million to $42 million. On-the-job construction deaths reached 33 in 2008, indicating “a strong correlation between construction fatalities and the characteristics of the underground economy,” according to the  report.

Even though they have been mislabeled, workers dubbed independent contractors are liable for taxes and fees that employers would otherwise be responsible to cover.

Workers often don’t pay, according to Matt Capece, a representative of the general president of the United Brotherhood of Carpenters who investigates payroll fraud. The tax revenue loss is compounded by employers who pay their workers off the books, shielding that income from states and the IRS.

Misclassification Prevalent Misclassification is prevalent in the construction industry where independent contractors often work alongside regular employees.

Contractors own their own business, work for different customers, control their hours, and are responsible for a portion of their payroll taxes, unemployment tax, or workers’ compensation insurance.

George Perry, a construction worker from Dayton, Ohio, did not fit that description. Still, he said he agreed in 2010 to be labeled an independent contractor as a condition for work building housing for the homeless under a federal grant.

“I went along with it because I felt my back was up against the wall,” Perry, 57, said in an interview. “I have a family. My fiance was in school. I’m the only bread winner.”

Prevailing Wage

Perry said he was initially paid $10 an hour, less than half of the prevailing wage for the type of work he was doing. He and his co-workers were told to file tax returns as if they were independent contractors or face layoff.

The following year he was hurt on the job leaving him unable to perform heavy work. After being terminated, he was denied unemployment benefits because he was wrongly labeled a contractor.

“There’s all kinds of losers and victims here,” Capece said in an interview. “Of course the workers. Good employers. State and federal governments are losing revenue.”

General contractors often use workers supplied by labor brokers who process paychecks and distribute tax forms, Capece said. Employers and labor brokers may use check cashing companies to hide payments to misclassified workers.

Labor Subcontractors “It’s a great system for the specialty contractor because they get the low labor rate of the law breaking labor subcontractor, plus they use that subcontracting relationship as a shield for liability,” Capece said.

Employers that refuse to use mislabeled workers may have higher labor costs than competitors and are often underbid on construction projects.

“It’s going to take a little time for the investigators to become savvy enough to understand what they need to see,” said Tennessee construction company executive Odom. “They’re going to have to learn what they need to look for when they go onto a job site. A lot of them have had their head in the sand.”

–Editor: Jon Morgan, Gail DeGeorge

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Director of Public Works and City Engineer Dan Takasugi is proposing the project to proactively fix trip-hazards all over Sonoma. Formally called the Sidewalk Trip-Hazard Repair Policy, Takasugi’s plan will divide Sonoma into 11 phases for cutting, starting in the Plaza and moving to areas with heavier foot traffic, with older sidewalk age and areas with “at-risk” populations (elderly and children, for example).

Takasugi initially presented this project to the City Council at its Aug. 19 meeting, noting that, historically, the City of Sonoma enforced the sidewalk repair ordinance by complaint only, and has not actively inspected sidewalks for trip-hazards.

Takasugi also explained that when repairs are too extensive to use the saw-cutting method – meaning a trip-hazard raised more than 1.75 inches – the city would share a portion of the repair costs with adjoining property owners who, many may be shocked to learn, have legal responsibility for the condition of sidewalks fronting their property lines. During the meeting, he noted the cost as anywhere from $600 to $1,500, but later stated costs would vary based on location and severity.

The project would be funded through the city’s general fund and Measure J tax dollars. It is budgeted at $50,000 per year, over the course of a proposed 11 year period, Takasugi said, with approximately half of the funding used for saw-cutting the minor trip-hazards, and the other half for cost-sharing repairs of larger trip-hazards.

Assistant Attorney John Abaci said there have undoubtedly been trip and fall cases in which an individual sued the City of Sonoma and the neighboring property owner. While no recent cases came to mind and liability in these lawsuits is determined on a case-by-case basis, Abaci said the city would like to avoid situations where it is named as a defendant. Under California’s Streets and Highway Code, explained Abaci, nearby property owners are responsible for maintaining sidewalks compliant with city code.

As outlined in the state’s code, cities can give abutting property owners notice to make repairs necessary to improve sidewalk safety conditions, but this requires a special assessment and a lien on the property when the hazard is not immediately taken care of by the owner, Abaci explained.

“My understanding from this proposal is to remedy those conditions that are found to be hazardous to the public and do it in a manor that will be more expedited instead of just sending out letters and going through a longer process,” Abaci said.

Takasugi’s plan uses the proprietary saw-cutting system of Precision Concrete Cutting, a national company with a branch in San Mateo. Company representative Joe Fouret explained, when the sidewalk is raised close to two inches, it cannot be cut using Precision’s method as it would weaken the sidewalk to a point that could create more cracks. In such a case, property owners will be given notice that they will have to fix the trip-hazard or share the cost with the city, Takasugi said.

The company’s unique method, said Fouret, aims not only to remove trip hazards through the saw cutting process, but also makes the sidewalk ADA compliant by ensuring proper slope and assessment of the area.

Precision has six patents on the specialized method, in which a crew of three people uses a diamond blade to saw the raised part of the sidewalk. “We are removing trip hazards from the ground up,” Fouret said, adding the small crew can repair up to 150 different hazards in day.

Fouret explained that most sidewalk deficiencies are caused by tree roots and said Precision’s method is especially efficient in Sonoma where there is a heritage tree law that protects some trees and requires certain precautions and specialized removal of trees in normal sidewalk repair methods. In areas where saw-cutting is possible, Fouret explained, trees will likely not be disturbed.

The first phase, which covers roughly five to six blocks, is slated to begin in November, said Takasugi.

Takasugi had been hopeful the project proposal would make it on the agenda for approval at the Sept. 16 City Council meeting, but the proposal is still being reviewed by the City Attorney and will likely be on the agenda later this fall.

To learn more about your property's insurance, call Elissa at 707-935-6294 x 102 or Email your question.

State Farm identified the top 10 states for dog bite claims paid with California and Illinois leading the pack. (Click here to see list)

The III said that the decline in the number of claims and increase in claim costs essentially offset one another so that total costs associated with dog bite claims in 2012 were virtually unchanged—down a mere 0.2 percent in 2012, the group said.

The rise in claims costs by even a small amount suggests that medical costs as well as the size of settlements, judgments and jury awards given to plaintiffs are still on the upswing, according to the III.

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Strategy #3: Get a FREE Prescription Savings card.  Using one of these cards can possibly get you a better price than even your own insurance company's discounted rate.FREE Sonoma Valley Insurance Rx Discount Card FREE Avia Partners Prescription Savings CardDrug SafetyCheck out this link to Healthline to check for:

• Drug Interactions
  
• Pill Identification
  
• Drug Comparison
  
• Brand Name vs Generic Name lookup

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“The notion that frivolous claims are routinely resulting in $100 million payouts is not true,” says study leader Marty Makary, M.D., M.P.H., an associate professor of surgery and health policy at the Johns Hopkins University School of Medicine. “The real problem is that far too many tests and procedures are being performed in the name of defensive medicine, as physicians fear they could be sued if they don’t order them. That costs upwards of $60 billion a year. It is not the payouts that are bankrupting the system — it’s the fear of them.”

Called catastrophic claims, payouts over $1 million are more likely to occur when a patient who is killed or injured is under the age of 1; develops quadriplegia, brain damage or the need for lifelong care as a result of the malpractice; or when the claim results from a problem related to anesthesia, the researchers found in a study published online in the Journal for Healthcare Quality.

Makary and his colleagues reviewed nationwide medical malpractice claims using the National Practitioner Data Bank, an electronic repository of all malpractice settlements or judgments since 1986. They looked at data from 2004 to 2010, choosing a 2004 start date because that is when data regarding the age and gender of patients and severity of injury became available for the first time. The information includes only payments made on behalf of individual providers, not hospitals or other corporations, meaning the number of payouts may be underestimated by 20 percent, Makary says.

Over that period, 77,621 claims were paid, and catastrophic claims made up 7.9 percent (6,130 payouts). The seven-year nationwide total of catastrophic payouts was $9.8 billion, representing 36.2 percent of the $27 billion worth of total claims paid over that time period.

The most common allegations associated with a catastrophic payout were diagnosis-related (34.2 percent), obstetrics-related (21.8 percent) and surgery-related (17.8 percent) events. Errors in diagnosis showed twice the odds of a catastrophic payout compared with equipment- or product-related errors and were associated with a roughly $83,000 larger payment.

The age of the physician was unrelated to the likelihood of a claim, suggesting inexperience is not necessarily a factor. But 37 percent of catastrophic payouts involved a physician with a previous claim in the database. The largest payout in the study was $31 million.

Makary says the data suggest that the focus of legal reform efforts should be on doctor protections aimed at reducing defensive medicine rather than the creation of malpractice caps.

He says his findings argue for more research to determine what interventions might prevent the type of errors that result in catastrophic payouts, with the overall goal of improving patient safety and reducing costs at the same time.

But real cost reductions, he says, will come from reducing the overuse of diagnostic tests and procedures.

Other Johns Hopkins researchers who contributed to this study include Paul J. Bixenstine, B.A.; Andrew D. Shore, Ph.D.; and Julie A. Freischlag, M.D.

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