D.C. Chamber, Board of Trade seek answers on paid leave proposal

D.C. Chamber, Board of Trade seek answers on paid leave proposal

Dec 2, 2015, 5:00am EST Updated: Dec 2, 2015, 8:20am EST

Joanne S. Lawton

Jim Dinegar, president and CEO of the Greater Washington Board of Trade, has serious concerns about the ramifications of a paid leave bill being considered by the D.C. Council.

Tina Reed

Staff Reporter- Washington Business Journal

When D.C. Councilman David Grosso, I-At large, proposed the most generous paid leave law in the country to employees in October, a major selling point was the cost would be broadly spread to make the benefit affordable.

Missing so far from the conversation: Hard numbers that support the plan.

"We keep hearing the bill itself was based on some study. That study still hasn’t been shared with us," said Harry Wingo, president of the D.C. Chamber of Commerce, which is opposing the legislation that will be discussed at a public hearing Wednesday.

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Among the major sticking points for the D.C. Chamber is the concern that the District hasn’t adequately examined what problem the legislation is trying to solve, Wingo said.

In October, Grosso introduced a bill that would extend up to 16 weeks of paid leave to employees throughout the District for major life events. The bill would require all nonfederal employers to pay into a city-managed fund to cover employee leave during qualifying events, such as the birth of a child or the illness of a family member.

But it’s not clear what the broader economic impact would be, how many people would be expected to take advantage or what the ultimate cost of this proposal would be, Wingo said. "It’s too far, too fast," Wingo said. "The business community supports District employees being able to take care of their families, but this could put businesses at a competitive disadvantage. We would first like a process that would first ask, ‘What is the problem we’re trying to solve?’"

In an emailed statement, Grosso said he worked with his staff to model the implications of such a robust program, including tax numbers, employee numbers and the preliminary findings of the Institute for Women’s Policy Research — a group commissioned by the Department of Labor to study the impact of paid leave.

Among those figures, the institute estimates there are about 481,000 private company workers in the District, about 230,000 federal workers, 44,000 self-employed individuals and 42,700 local government employees. The estimated benefit levels for men and women in D.C. ages 25 to 34 — prime child-bearing years — is about $1,173 and $1,230, respectively.

The estimated length of leave time for women under 45 is 6.69 weeks for bonding and 2.99 weeks for family care. For men under 45 years old, the estimated amount of leave time is 3.2 weeks for bonding time and 2.16 weeks for family care. The average cost of family medical leave for private sector workers in D.C. is about $34.1 million in benefits.

"I understand the desire of constituents and business leaders to have more sophisticated models and deeper sets of numbers, but the fact of the matter is that introducing the bill was necessary to have this conversation," Grosso said. "Now as the bill moves through the hearing process at the council, I am working closely with our Chief Financial Officer [Jeffrey DeWitt], Chairman [Phil] Mendelson, businesses and advocates to fill out the details of what options we have for providing the best amount of paid family and medical leave for the maximum number of D.C residents, being sure to cover those low-income workers who are least likely to have access to leave.”

Grosso has won plenty of support on the council, as well as from family advocates, who say similar laws in California and New Jersey have improved worker retention with little negative impact on employers. A survey commissioned by the Campaign for D.C. Paid Family Leave found about 80 percent of D.C. residents support for the bill, even after hearing opponents’ messages.

"The truth is, the U.S. is just woefully, horribly behind the curve when it comes to paid leave in the modern, global business world," said Barbara Gault, vice president and executive director of the Institute for Women’s Policy Research. She said the institute had submitted its report to D.C. government recently but did not have the authority to release it prior to its review.

Some small D.C. companies have indicated they’d welcome the ability to offer the benefit that might otherwise be too costly.

However, the resounding response from the business community has been one of concern, said Greater Washington Board of Trade President and CEO Jim Dinegar. A 1 percent tax on employers, a part of the proposal, would put both D.C. companies and D.C. residents at a major competitive disadvantage, he said. The proposal would require employers to pay up to 1 percent of their payroll depending on their workers’ pay. "This approach is one-size-fits-all and we don’t think it fits at all," Dinegar said, referring to the requirement all businesses provide the benefit.

While many have pointed to the success of paid leave laws in California and New Jersey, neither of those states is completely surrounded by its competitors like D.C., Dinegar said. And in both those states, employees pay for the benefit through payroll taxes, Dinegar said. In a recent Washington Post poll, a majority of workers supported the idea of paid leave, but also indicated they didn’t want workers to have to pay for it.

Dinegar said there are too many lingering questions about how the legislation would work, including who would determine qualifying events, such as when a person intends to take time for what’s been called "self-care" in the proposal.

"We’re not trying to slow this down," Dinegar said. "But where was the homework that was supposed to be done to craft this proposal?"

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016


WSJ Editorial: UnitedHealth’s ObamaCare Reckoning

UnitedHealth’s ObamaCare Reckoning

Insurers are learning that the law was a Faustian bargain.

Updated Nov. 22, 2015 9:06 p.m. ET


Health insurance stocks took a nasty tumble last week, and maybe the markets are realizing that ObamaCare isn’t performing as well as the political class pretends. Sooner or later, reality tends to assert itself—for President Obama’s domestic legacy no less than his foreign policy.

The immediate cause of the selloff was UnitedHealth Group’s shock $425 million downgrade to its earnings forecast for 2015, almost entirely driven by losses on the Affordable Care Act exchanges. UnitedHealth is the largest U.S. insurer by enrollment, and the company is warning it may withdraw from ObamaCare in 2017. The insurer has already suspended advertising for its ObamaCare coverage and stopped paying commissions to insurance brokers for signing people up. It literally doesn’t want consumers to buy its products.

On a UnitedHealth call Thursday with Wall Street analysts, Josh Raskin of Barclaysasked, “Simply, how long are you willing to lose money in exchanges?” and then followed up, “Are you willing to lose money again in 2017, Steve?” UnitedHealth CEO Stephen Hemsley replied: “No, we cannot sustain these losses. We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself,” adding that “we saw no indication of anything actually improving.”

UnitedHealth reported one problem after another: An expensive risk pool that lacks the younger and healthier consumers who are supposed to buy overpriced plans to cross-subsidize everyone else. Enrollment growth continues to lag. People join the exchanges before they incur large medical expenses—insurers are required under ObamaCare to cover anyone who applies—and then drop out after they receive care. The collapse of the ObamaCare co-ops is recoiling through the market.

UnitedHealth sat out the first year of ObamaCare but then did a big-bang expansion for 2015-2016, offering coverage on 24 of the 34 federal exchanges, and it now covers some 540,000 people. Morgan Stanleyestimates UnitedHealth’s average premium increase for 2016 was 9%, so the company was rationally raising prices to offset rising costs. It still thinks it will lose money.

The reason the UnitedHealth disclosure jolted investors is that other insurers are almost certainly experiencing the same problems. Companies accountable to shareholders are not charities, and for all the new regulatory control that ObamaCare imposed on the industry, the government can’t force them to do business. (Not yet, anyway.) But the law is ever more obviously the Faustian bargain that we predicted and that insurers should have known better than to accept when they lobbied for the bill in 2009.

None of this means ObamaCare is rapidly “collapsing under its own weight,” as some Republican like to imagine. The entitlement will continue to trundle along, especially as it becomes ever more a vast Medicaid expansion. Commercial insurers are being displaced by Medicaid managed-care HMOs, with their ultra-narrow physician networks and closed drug formularies.

Then again, this trend is itself another symptom of decline. While liberals can continue to insist all is well, businesses don’t enjoy the same political luxury.

The Push for Black Teen Adoption

The Push for Black Teen Adoption

DISB Re-accredited by the National Association of Insurance Commissioners

For Immediate Release
Nov. 23, 2015
Contact: Kate Hartig, (202) 442-7753

DISB Re-accredited by the National Association of Insurance Commissioners
This certification represents a continuation of excellence in the District’s insurance regulation

Washington, D.C. – The District of Columbia Department of Insurance, Securities and Banking (DISB) received accreditation for another five years by the National Association of Insurance Commissioners (NAIC) on Nov. 18. DISB has been accredited since 1995.

“The NAIC accreditation demonstrates that DISB continues to meet national standards for regulating insurance companies operating in the District,” said Commissioner Stephen C. Taylor. “It is a credit to the hard work of DISB’s staff to ensure we maintain this important regulatory certification for the protection of District of Columbia residents.”

The purpose of NAIC’s Accreditation Program is to develop and maintain national regulatory standards for insurance company solvency. To achieve accreditation, DISB had to demonstrate adherence to legal, financial and organizational standards as determined by a committee of its state regulatory peers.

The NAIC Financial Regulatory Standards and Accreditation Committee voted to approve DISB’s accreditation during the NAIC Fall Annual Meeting last week in National Harbor, Maryland.

DISB monitors the solvency of insurance companies and captive insurance companies operating in the District.

To read more about NAIC’s Accreditation Program, follow this link.

Major insurer may leave ObamaCare

Major insurer may leave ObamaCare

By Sarah Ferris, The Hill – 11/19/15 11:23 AM EST

One of the country’s largest health insurers warned Thursday that it may leave the ObamaCare exchanges within two years, delivering a shock announcement that could ripple through the marketplace.

At a shareholder meeting Thursday, UnitedHealthcare cast doubt on its ability to carry plans on the healthcare law’s exchanges beyond 2016, offering a more grim financial outlook than it had previously expected.

“In recent weeks, growth expectations for individual exchange participation have tempered industrywide," said Stephen Hemsley, the company’s CEO.

"Co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step,” he said.

The company’s statement said it will be “evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.”

It also projected that its fourth-quarter revenue will be $425 million less than expected — amounting to 26 cents in earnings per share.

The company also announced it has “pulled back” on marketing plans for 2016.

Hemsley’s mention of the ObamaCare co-operatives, or co-ops, refers to the half-dozen startup insurers that have collapsed in the past few weeks.

Opponents of the healthcare law have seized on the closure of the co-op insurers, which were intended to increase competition, and highlighted the troubles in hearings on Capitol Hill.

Fewer than half of the original 23 co-ops are still running, and only a handful are on solid financial footing.

mayor’s newsletter — standing with Paris

November 19, 2015 | Volume 1, Issue 41

Dear Washingtonians,

Like all Americans, I was devastated by last Friday’s atrocious attacks in Paris. Washington stands with our sister city, and our thoughts and prayers are with the victims, their families and their community.

When Paris Mayor Anne Hidalgo visited our city in February, she came to see me at the John A. Wilson Building. We talked about the importance of promoting tolerance and inclusion in diverse cities like ours. And this June, we met again and shared a stage with Montreal Mayor Denis Coderre and mayors from around the world, where we discussed how residents from diverse backgrounds can live and thrive together in communities across the globe. We stood together then, and we stand together now.

If you would like to send a message to those affected by the attacks, you can sign the French Embassy’s condolence book.

As always, here at home we are focused on the safety and security of our city. I want to stress that there is no credible threat to the District at this time.

My team and I are working closely with our regional and federal partners to adjust the District’s security response, as needed. I have spoken directly with U.S. Secretary of Homeland Security Jeh Johnson, met with U.S. Attorney General Loretta Lynch and have worked with Metropolitan Police Department Chief Cathy Lanier to remain in constant communication with our regional safety partners. In addition, out of an abundance of caution, we have deployed additional law enforcement resources across the city — some of which are visible, while others are not.

I want to remind everyone: if you see something, say something. Please call 911 immediately if you notice any suspicious or criminal activity.

In the meantime, we’ll continue to pray for Paris.


Muriel Bowser

With Mayor Hidalgo in February (left) and at the French Embassy in DC, earlier this week (right)

The Price of Price Optimization in Insurance

View this article online: http://www.insurancejournal.com/news/national/2015/11/17/389153.htm

The Price of Price Optimization in Insurance

The use of price optimization in insurance pricing is drawing increased attention and could be the next big industry battle.

Or it could not be.

Consumer groups and a growing contingent of states are labeling the practice as unfairly discriminatory and restricting it. Insurers say there is confusion over exactly what price optimization is and claim that these same watchdogs have for years approved elements of what some are now calling price optimization.

Meanwhile, agents are acting like they hope the whole controversy will just fade away and they may get their wish.

While a full definition is hard to come by, price optimization generally refers to an insurer’s practice of varying rates based on non-risk-related factors. Price optimization involves analysis and incorporation of data not related to expected cost for risk characteristics — that is, it involves factors not related to expected loss and expense experience. Such data may include the prior year changes in premium and whether policyholders renewed subsequent to such change.

The exact number or identity of insurers using price optimization is unclear; however, nearly half (45 percent) of large insurance companies and 26 percent of all insurance companies in North America currently optimize prices, according to a 2013 survey by Earnix, a software provider of price optimization products to the insurance industry.

Regulators in 11 states (California, Delaware, Florida, Indiana, Maine, Maryland, Ohio, Pennsylvania, Rhode Island, Vermont and Washington) and the District of Columbia have issued bulletins prohibiting or restricting the use of price optimization in personal lines ratemaking.

A task force of casualty actuaries of the National Association of Insurance Commissioners (NAIC) has taken on the issue as well. In October, it issued an updated price optimization white paper that provides background research, identifies potential benefits and drawbacks of its use in personal lines, and presents options for state regulatory responses.

What Is Price Optimization?

Price optimization is not a new concept — it has been used in the retail and travel industries for years. But there is no widely accepted method and definition of it in the insurance industry.

Some refer to price optimization as relying on predictive modeling and “big data” while others refer to price optimization to mean using information about consumers’ price sensitivity as a rating factor.

For insurers, this definition uncertainty is the problem.

That “lack of consensus” has led regulators to question some pricing techniques that have been used by insurers for decades, according to Robert Hartwig, president of the Insurance Information Institute, in testimony at the National Conference of Insurance Legislators in July.

“The lack of consensus definition has clearly sewn confusion and led states to question substantively different pricing techniques, some of which regulators had approved for decades, potentially leading to unintended and adverse consequences for consumers,” Hartwig said.

“The use of judgment in ratemaking is universally recognized and accepted by regulators and falls within the scope of the actuarial standards of practice,” he said.

Hartwig contends that PO is consistent with actuarial principles, which recognize that business considerations are part of ratemaking and the indicated rate for an insurance product and the market price are different in most circumstances.

Quoting the Casualty Actuarial Society’s (CAS) statement of principles, Hartwig added, “By interacting with professionals from various fields including underwriting, marketing, law, claims, and finance, the actuary has a key role in the ratemaking process.”

Hartwig cited young drivers as an example of where judgment enters into in ratemaking.

“As high as rates are on newly-licensed drivers, those rates would be higher still if companies did not exercise judgment and instead took the full rate indication for this class of driver,” he said. “Regulators have never objected to this pricing behavior, which strays from strict adherence to indicated rates but reflects market realities.”

Florida has its own definition. In its bulletin from May 2015, the Florida Office of Insurance Regulation defined price optimization as: “a process for modifying the insurance premium — that would otherwise be charged to an insured or class of insureds — in order to maximize insurer retention, profitability, written premium, market share, or any combination of these while remaining within real world constraints.”

In general, price optimization uses the economic concept of “price elasticity of demand,” which is a measure of the responsiveness of the quantity of a good or service purchased to a change in its price. Advocates of price optimization have pointed to such non-risk-related items as cross-selling opportunities, consumer retention, and conversion rates as potential benefits of the process.

However, according to Florida and other states opposing the practice, “it is possible for an insurer to use price optimization or price elasticity of demand for the purpose of price discrimination, which is when the insurer charges different prices for the same product to different market segments with reduced regard for expected losses and expenses.”

When it is used in this way, price optimization results in rates that are unfairly discriminatory in violation of Florida law, Florida’s regulators say.

Regulators complain that price discrimination can give a bargain to one consumer over another with the same risk.

For example: Consumer A and consumer B are both women of the same age residing in the same state, with similar driving records, credit history, and other factors. Both A and B have bought auto insurance from the same carrier and pay the same premium. But now A is discovered by the carrier to be browsing multiple insurer websites looking for a better deal on her car insurance, prompting the insurer to gives her a 10 percent discount. B is not browsing for a better deal online and gets no such offer.

This difference in treatment is potentially unfair, regulators say.

“We’ve got no problem with an insurer modeling its expected costs related to a particular policyholder on traditional factors like driving history, and then pricing the risk accordingly,” said Lee Barclay, senior actuary at state of Washington’s Office of the Insurance Commissioner, in a May 2015 article on CarrierManagement.com, titled “Price Optimization or Price Discrimination? Regulators Weigh In.”

“But this is modeling a consumer’s behavior insofar as their likelihood of renewing with an insurer,” Barclay added. “When you are modeling things other than the risk that will be transferred from the policyholder to the insurer, we have concerns.”

Voodoo Pricing

Consumers whose premiums change for no apparent reason often turn to their agents for an explanation.

But thus far, the nation’s largest association of independent agents and brokers has remained quiet on the issue of price optimization, although it is keeping its eye on it.

When price optimization results in a policy discount that’s good news from an agency standpoint, but when somebody’s auto insurance takes a premium hike, that makes an agents role more difficult, says Bill Wilson, director of the Virtual University at the Big “I” (Independent Insurance Agents & Brokers of America).

“If somebody has a $200 jump in their premium, they ask the agent why. If they know it’s pricing optimization, how do you tell somebody, ‘Well, the insurance company is going to charge you as much as they possibly can before you move your business,’” Wilson said. “That makes it so tough for an agent.”

He is concerned about the effect on consumer trust in the industry.

“With the disdain that so many consumers have for the industry, I think a lot of them will suspect price optimization is some kind of voodoo pricing system,” Wilson said.

Wilson says data-driven tools in insurance pricing are interesting, but also scary. “Particularly when you’re trying to explain this to consumers that don’t really understand the industry to begin with, and are at best, highly suspicious of what we do, and how we do it.”

Wilson also has concern over the reliability and the accuracy of the data, stemming from his own personal experience. “I’ve had two personal experiences where I’ve had homeowners’ rate hikes that were attributable to credit scoring. Both of them were in error,” he said.

Wilson’s expertise in insurance led him to “pick up on” the mistake and get it fixed. “One was a $1,000 homeowners’ increase, because they had used the wrong credit data. They used it for a different Wilson couple,” he said. The other mistake resulted in a $700 rate increase that also turned out to be a mistake.

Wilson admits that at some point the Big “I” may have to take an official stance on the use of price optimization with independent agency carriers. That is if the issue continues to remain an issue.

Price optimization may end up being a “non-issue if, universally, regulators don’t permit it,” he said. Right now the Big “I” continues to take a “look and see” approach to price optimization.

Wilson says the Big “I” plans to offer a webinar on predictive modeling, data analytics, price optimization, and other issues affecting the pricing structure of various types of insurance in February 2016.

For now, the Big “I’”s Wilson says agents understand the value of data to make risks more predictable, and that helps control the pricing. He hopes the focus will continue to be on risk-based underwriting rather than optimizing prices on non-risk-based factors.

“As long as they don’t factor too much [price optimization] into the rate, it is risk-based,” he said hopefully.

The Big “I” may not be ready to take a position but others are.

According to Frederick Fisher, J.D., of Fisher Consulting Group Inc. in El Segundo, Calif., price optimization is all about how insurers can get more money out of their insureds but they may come to regret going down its path.

“The concept of price optimization is going to get a lot of people in a lot of hot water and, possibly, even give rise to significant underwriting losses, especially in such a competitive environment,” Fisher said, who consults on loss control, provides expert witness work, litigation strategies, and coverage management and review for policyholders.

In his view, insurers do not need price optimization to turn a profit.

Insurance company profitability “still boils down to what’s going to cause the losses, what’s the probability of that taking place, and finally can we set forth a pricing mechanism that’s going to make sense and leave us with a profit,” Fisher said. “What you want to do is stay within the actuarial model. As long as you’re staying within the actuarial model, I’ve never known anybody that didn’t make money … It all goes back to assessing the risk, which price optimization does not.”

In Fisher’s view, price optimization may not be around for long.

“It’s very clear that the departments of insurance are not going to allow price optimization — simply because you think you can get more money here versus more money there — without that being associated with some change in hazard risk,” he said.

Even with varying state definitions of what price optimization is (or is not), Fisher says there’s one thing that’s in common with them all — and that is that pricing optimization has nothing to do with the risk.

“I don’t know that a reinsurer is going to be too crazy about a price optimization, when there’s no hazard justification behind it,” he said.

Wells is editor-in-chief of Insurance Journal magazine, where a version of this article originally appeared.