Can You Really Keep
Your Doctor with a
Narrow Network?
- Page 1
How to Prevent
Burglaries During
Vacations - Page 2
Who is Liable When
a Tree Falls on a
Neighbor’s Property?
- Page 3
Protect Your Home Against
the Rising Threat of
Earthquakes - Page 4
One of the key selling points of the
Patient Protection and Affordable
Care Act (PPACA), commonly known
as health care reform was the promise
that “you can keep your doctor,
period.”
However, millions of Americans who
have or will be signing up for medical
coverage via the online Exchange or
Marketplace may be in for a surprise.
Some of the plans available on the
Marketplace impose significant
network restrictions, and in many
cases do not provide in-network
coverage to the most sought-after
hospitals, clinics and physicians in
their markets.
The Issue
In order to control costs, the health
insurance industry relies greatly on
the managed care model employed
by health maintenance organizations
(HMOs) and preferred provider
organizations (PPOs).
How It Works
Managed care organizations try to
get as many subscribers as possible
within a certain market, such as a
city, state or zip code. They then
approach the medical care providers
in the community and use their
large subscriber base as a bargaining
chip. They offer the medical care
March 2014
InsuranceInsights
A NEWSLETTER FOR CLIENTS AND FRIENDS OF BANCORPSOUTH
INSURANCE SERVICES, INC.
Can You Really Keep Your Doctor
with a Narrow Network?
provider or institution the prospect
of a significant flow of referrals.
In exchange, they ask hospitals
and clinicians to take a much
lower reimbursement rate.
The arrangement is known
in health care circles as the
“narrow network” concept.
The smaller the network,
the more value the stream of
referrals has to those providers
included in the network. Expanding
the network to too many care
providers also dilutes the value of the
stream of providers.
The Result
The system favors the lowest cost
providers. The best specialists and
hospitals with higher fees, who have
invested in technology and training,
are sometimes locked out of the
process since they cannot underbid
the low-cost providers.
Exclusions Abound
Across the country, individuals
purchasing or shopping for coverage
on the Marketplace are discovering
that some plans do not cover the
best local hospitals. For example, the
venerated Cleveland Clinic accepts
dozens of private health plans offered
via independent health insurance
brokers and through carriers outside
of the Marketplace. But if you buy
your plan through the Marketplace in
Ohio, only one plan out of the twelve
offered provides in-network coverage
to the Cleveland Clinic.
As another example, Southern
California Health Net has announced
that individual plans sold via the
Welcome to the BancorpSouth Insurance Services, Inc. Newsletter!
Marketplace will have access to
less than a third of the number
of doctors available via employer
plans. Furthermore, while all the
Marketplace plans include the Los
Angeles County hospital system, most
of them will not provide in-network
coverage to the most respected
private hospitals like Cedars-Sinai, or
the top research hospitals like UCLA.
Additionally, Seattle Children’s
Hospital, a popular and respected
institution in Seattle, Washington,
filed a lawsuit against the state for
excluding their hospital from the
Marketplace. Of the seven plans
available in King County, only two of
continued on page 3
To locate an office near you,
please visit us online at
www.bxsi.com or contact us at
info@bxsi.com.
I hope that you find these articles of interest. If you have a topic for future discussion, please let
me know. Please call anytime we can answer questions or be of help with your business or per
sonal insurance needs.
How to Prevent Burglaries During Vacations
Before taking off on vacation, it
is important for homeowners to
make sure they will not return to an
empty or burglarized home. Experts
recommend several tips for avoiding
burglaries while on vacation.
Give the impression that someone
is always home. When thieves case
neighborhoods for potential targets,
they look for patterns. If they notice
a home’s lights are always off and
mail or fliers are piling up, they
know the residents are gone. Before
leaving, ask that mail be held or
forwarded temporarily. If possible,
ask a neighbor to remove any fliers
or cards from a gate or your front
door. It is also important to have
lights come on frequently. Set timers
for lamps in various parts of the
house. Setting a television to record
shows and turn on automatically can
also be helpful. If there is grass in
the yard, arrange for it to be mowed.
Leave a few blinds or curtains
partially open to give the appearance
that someone is home. If there is a
land phone in the home, lower the
ringer volume so it is not audible
outdoors. Also, make sure the
volume on the answering machine is
turned down low.
Make the home burglar resistant.
Doors should be secured with doublecylinder locks instead of doorknobs,
and it is important to use deadbolt
locks whenever possible. To be
effective, deadbolt locks should
fit one and one-half inches into a
doorframe. You can also reinforce
the locks by using metal doorframes
or panels, which are much more
difficult to pry open than wood
frames. If there are sliding doors such
as patio doors, put wooden sticks or
broom handles in the tracks behind
the doors. This will make it nearly
impossible for thieves to pry these
doors open. Every window in the
house should be locked and secured.
Keep in mind that it is also possible
to secure windows with key locks.
Do not give burglars a reason to
break in. Any valuable paintings,
decorations or antiques should be
placed away from windows where
they are not easily visible from
outside. If there are extra keys
for the home, do not leave them
above frames, in flower pots, under
doormats or in the mailbox. Think
of more creative places to put them,
or simply give a key to a trusted
friend, family member or neighbor to
check in when needed. Any valuable
jewelry or large amounts of cash
should be put in a safe deposit box
while the home is vacant.
Have a trusted person watch the
home. Surveillance systems and
alarms are good for catching thieves,
but having a person check in on
the home is still one of the best
deterrents for burglars. Notify a
trusted neighbor, friend or family
member about an upcoming
vacation, and ask that person to stop
in from time to time.
Review your homeowners insurance
policy. Before leaving for vacation,
talk to your BancorpSouth
Insurance Services representative
to ensure your home is adequately
insured. Make a list of all personal
belongings, and make sure any art
or valuables are specifically insured.
Making a list is also a good way to
have something to identify what
belongings were taken in the event
Doors should be
secured with doublecylinder locks instead
of doorknobs, and
it is important to
use deadbolt locks
whenever possible.
of a burglary. After the holidays,
if you receive expensive gifts, you
should discuss your new belongings
with your BancorpSouth Insurance
Services representative. To cover
these belonging, you may need a
separate policy, endorsements or
name items on your existing policy.
New computers, jewelry, collectibles
and expensive art are common
examples. If a policy is not properly
updated, some items will not be
covered if they are stolen.
continued from page 4 ... Protect
Your Home Against the Rising Threat
of Earthquakes
homeowners to have this vital
coverage. Experts point out that it is
not only vital for California residents
but also residents everywhere.
No one knows when or where an
earthquake will happen, and it is
best to be prepared instead of facing
catastrophic financial losses.
It is important for homeowners
to remember that earthquakes
are not covered under standard
homeowners insurance policies.
To obtain coverage, you must add
earthquake coverage to your policy
or purchase a separate earthquake
insurance policy. To learn more
about earthquake coverage, contact
your BancorpSouth Insurance
Services representative.
Page, Morgan T., and Susan E. Hough.
“The New Madrid Seismic Zone: Not
Dead Yet.” Science 343.6172 (2014):
762-764. Science Mag. Web. 17 Feb.
2014.
Who is Liable When a Tree Falls on a Neighbor’s Property?
Trees provide shade and complement
landscaping nicely, but they can also
cause major disputes when they fall.
A tree may fall if it is not properly
maintained, diseased or during
a storm. When a tree falls onto a
neighbor’s property, a homeowner
often wonders if he or she is liable.
Most people assume that they are
liable since it is their tree. However,
this is not always the case.
When a tree falls onto a neighbor’s
property, the neighbor should submit
a claim to his or her insurance
company immediately. The insurance
company is usually responsible for
taking care of the damages. This is
true if the tree fell over due to an
act of nature. For example, a healthy
tree that falls over during a tornado,
hurricane, wind storm or winter
storm would not be the responsibility
of the homeowner. Since the
homeowner living on the property
where the fallen tree was rooted did
not intentionally push the tree over,
nature is responsible. This means
that the neighbor’s insurance policy
would typically cover it.
However, there are some cases where
a homeowner could be held liable.
If the tree fell on the neighbor’s
home when the homeowner was
trying to cut down the tree without
professional help, the damage would
be the homeowner’s responsibility.
Also, if the tree was dying, unstable
or diseased and the homeowner
knew about it, he or she could be
liable if it falls on its own. He or she
could also be liable if it falls during
a very light storm that would not
normally knock over a tree. When
homeowners know they have dying,
diseased or unstable trees, it is their
responsibility to take steps to prevent
them from causing severe damage.
In the event a homeowner is liable
for the damages, his or her personal
insurance company will have to pay
the damages if it is covered under
the insurance policy. The insurance
company may also investigate the
claim and defend the homeowner
in a lawsuit by the neighbor
whose property the tree fell on.
If the neighbor sues for losses,
loses, the
the
homeowner’s insurance company
will pay up to the policy limit for
damages. For any further damage
costs, the homeowner is financially
responsible.
Most cases involve trees falling due
to storms or acts of nature, so many
homeowners whose trees fall over
do not have to worry about their
insurance company footing the bill.
In some cases, neighbors may still try
to sue to recover their deductibles.
The best way to avoid this scenario
is to prevent it in the first place.
Homeowners should check their trees
regularly and have them inspected at
the first sign of disease or any health
issues.
A professional arborist can analyze
the tree to see if it needs any special
treatments, pruning or complete
removal. This may seem like an
unnecessary expense, but it is much
less expensive than the potential cost
of paying for damages to a neighbor’s
home and legal costs. It is best to
try to keep peace with neighbors, so
this is also a good way to prevent
quarrels or ongoing problems. To
learn more about damage claims
from fallen trees, discuss your
concerns with your BancorpSouth
Insurance Services representative.
For example, a
healthy tree that
falls over during a
tornado, hurricane,
wind storm or winter
storm would not be
the responsibility of
the homeowner.
continued from page 1 ... Can You
Really Keep Your Doctor with a
Narrow Network?
them provide in-network coverage
for Seattle Children’s Hospital.
“The notion that a major insurance
plan is going to exclude us from
their network is truly precedent
setting,” said Sandy Meltzer, a
physician and the hospital’s senior
vice president, in an interview with
the Seattle Times. “It represents
a new level of degradation in
children’s access to care.”
The Bottom Line
When it comes to health insurance,
the monthly premium cost is only
a small part of the big picture.
The proper way to evaluate any
health insurance policy is not just
premium. Instead, you should
consider if you are going to be
to be satisfied with your care
options in the event you have a
claim. That’s why you should look
carefully not just at your premium
and deductible, but also read the
fine print and find out whether
you will have access to the best
providers in your area.
Some insurance carriers have opted
out of the Marketplacefor a variety
of reasons. Your BancorpSouth
Insurance Services representative
may have alternative options for
medical coverage. Contact your
BancorpSouth Insurance Services
representative to learn more.
Protect Your Home Against the Rising Threat of Earthquakes
Recent research shows that about 10
percent of American homeowners
have earthquake insurance. In
2012, the percentage was slightly
higher. Western states had a higher
concentration of homeowners with
earthquake insurance coverage.
However, the number had decreased
from 27 percent in 2012 to 22 percent
in 2013.
When the famous Northridge
earthquake happened 20 years ago,
nearly 30 percent of homeowners in
California had earthquake insurance.
However, they estimate that the
number of California homeowners
with this type of insurance today is
only about 10 percent. Although the
number of people buying coverage
has become lower, the possible costs
of earthquake damage have only
grown. This is partially due to the
constant growth of urban areas and
the vulnerabilities of older buildings
and often building owners do not bring
older buildings up to code.
Earthquakes are not only a threat to
Westerns states.
Since 1900,
experts say that
earthquakes have
happened in all
50 states in the
United States.
In 2011, a 5.8
magnitude earthquake in Virginia was
so strong most of the people along
the East Coast felt it. The big 6.7
magnitude quake in Northridge hit on
January 17, 1994. Experts say that it
was the most expensive earthquake
in history costing an estimated $15.3
billion in insured damages alone.
When calculated with inflation
increases, that would be about $24
billion if the same quake and damages
occurred in 2013. This damage amount
is comparable to Hurricane Katrina,
Hurricane Andrew and the famous
attacks on the World Trade Center.
According to United States Geological
Survey (USGS) seismologists Morgan
Page and Susan Hough, found that the
threat of earthquakes in the central
United States is on the rise. The
study monitored earthquake activity
in parts of Arkansas, Illinois, Indiana,
Kentucky, Mississippi and Tennessee
and found that the stress along this
zone is not decreasing but rather
building towards another earthquake
threat.
Although there have not been any
events quite as devastating as the
Northridge quake, California is still
the state that is most at risk for a
huge earthquake. During the 30 years
preceding the quake in Northridge,
experts say that insurance companies
received less than they paid out
for that quake alone. Earthquake
insurance costs have certainly
increased since the Northridge
incident, but it is still important for
continued on page 2
Information contained in this newsletter about product offerings, services, or benefits is illustrative and general in description, and is not intended to be relied on as complete
information. While every attempt is made to ensure the accuracy of the information provided, we do not warranty the accuracy of the information. Therefore, information should
be relied upon only when coordinated with professional tax and legal advice.
BancorpSouth Insurance Services is powered by BancorpSouth Bank; a wholly-owned
subsidiary of BancorpSouth Inc., a $13.4 billion-financial holding company based in Tupelo,
Mississippi. BancorpSouth Insurance Services is annually ranked as one of the nation’s
largest brokers by Business Insurance magazine. Equipped to service clients across the globe
through our Worldwide Broker Network relationship, we have over 30 offices with almost
600 insurance and risk management professionals ready to serve.
InsuranceInsights