Consumer eViews
     FLORIDA CHIEF FINANCIAL OFFICER ALEX SINK'S WEEKLY NEWSLETTER
    
Volume 5, Number 1, January 4, 2008

Starting this week, Florida drivers are once again required to carry personal injury protection (PIP) coverage under legislative reforms made to Florida’s Motor Vehicle No-Fault Law. As part of the new legislation, insurance companies must notify policyholders how the mandatory restoration of PIP will impact them.

As Chief Financial Officer, the centerpiece of CFO Sink's role is to educate Floridians about important financial issues. To help, here is a summary of key legal reforms that took place on January 1, 2008, to Florida’s Motor Vehicle No-Fault Law.

  • Florida motor vehicle owners and operators will be required to carry PIP in the amount of $10,000 for losses sustained by the insured or covered person as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.
     
  • By law, PIP coverage pays the following benefits, up to the $10,000 limit: 80 percent of reasonable and medically necessary medical expenses; 60 percent of disability benefits for lost gross income and earning capacity; 100 percent of replacement services (such as child care, housekeeping, etc.); and $5,000 per individual death benefit.

If you need assistance, we encourage you to contact your insurance agent or healthcare provider or call our Consumer Helpline at 1-877-MyFLCFO.


DOZENS OF FLORIDIANS ACCUSED OF FRAUDULENTLY OBTAINING
DRIVER LICENSES, RISKING NATIONAL SECURITY

Seven arrested in ongoing investigation that may lead to hundreds of arrests

Florida Chief Financial Officer Alex Sink announced the arrests of seven Floridians accused of posing a risk to Florida’s and the nation’s security by fraudulently obtaining Florida Commercial Driver Licenses (CDLs). The investigation is ongoing and authorities believe hundreds of individuals are involved, with additional arrests anticipated. Some will also be charged with insurance application fraud.

Between November 2005 and April 2007, civilians who had never been in the military fraudulently obtained a United States Department of Defense waiver form. The waiver indicated that the holder had been trained by the United States Army to operate heavy vehicles. Some of these individuals, who had never received or completed the required training, used these fraudulently obtained CDLs to obtain either personal or commercial vehicle insurance.

“This scheme posed a risk to our nation’s security and put others on the road in jeopardy because these drivers did not have the training they claimed to have,” said CFO Sink. “I thank all of the law enforcement agencies involved for working together to protect Floridians and our nation.”

CFO Sink, who oversees the Department of Financial Services’ Division of Insurance Fraud (DIF), said that today’s arrests follow an investigation by DIF, the U.S. Department of Defense - Defense Criminal Investigative Service (DCIS); U.S. Immigration and Customs Enforcement (ICE); the Florida Highway Patrol, and the Florida Department of Transportation Motor Carrier Compliance Office.

Steven Baez, a sergeant with the Army National Guard stationed at the Homestead Air Reserve Base in Homestead, sold each waiver form, Operator Qualification Record DA FORM 348-E, for as little as $400 and as much as $1,300. Baez pled guilty in October to one count of conspiracy to cause the production of false identification documents and two counts of bribery of a public official and faces up to 15 years in prison. His sentencing is scheduled for January 16, 2008, before U.S. District Court Judge Marcia G. Cooke. Today’s arrests are being prosecuted in Miami-Dade County and sentences upon conviction could range from five to 10 years in prison.

“Today's arrests clearly demonstrate our commitment to thwarting identity theft and document fraud,” said Anthony Mangione, special agent-in-charge of ICE investigations in Miami. “Document fraud involves efforts to obtain genuine identity documents through fraudulent means and the alteration of valid documents to be used for fraudulent purposes. Identity and document fraud pose a clear national security threat and we will continue working tirelessly to identify, arrest and bring to justice those involved in these illegal schemes."

Special Agent in Charge Christopher Amato, of the Pentagon's Criminal Investigative Service, Southeast Field Office, stated, "The fraudulent use of Department of Defense resources by a military member to violate the integrity of our infrastructure is taken very seriously by the DCIS. The DCIS will continue to play a vital role in the ongoing efforts to better secure and protect our nation from both external threats and internal corruption."

Anyone who purchased one of these fraudulent waivers or has additional information is urged to cooperate with the investigation by calling DIF Lt. Bill Santner at 305-536-0355.

Those arrested today are:

DIAZ, GREGORY – DOB 11/27/1984, Miami
DIAZ, LINA BELKIS - DOB 12/19/1964, Miami
DIAZ, LUIS ENRIQUE - DOB 4/12/1969, Miami
FERNANDEZ, JOSE – DOB 12/19/1983, Homestead
MONTESINO, JESUS LUIS - DOB 8/15/1959, Miami
RAMOS, ADALBERTO – DOB 11/28/1967, Miami
RAMOS, JACINTO – DOB 9/11/1968, Homestead

These individuals were booked into the Turner Guilford Knight Correctional Center.


WHY SHOULD YOU MAKE AN INVESTMENT TO STRENGTHEN YOUR HOME AGAINST HURRICANES?  We’ve got three good reasons:

Reason 1: A free wind inspection. Before you can improve your home’s ability to withstand a hurricane, you need to know how hurricane resistant it is today. The inspection will be conducted by a
qualified wind inspector trained in wind-resistant building techniques.
Following the inspection, a detailed report will be provided to you that will:

  1. explain and prioritize what improvements can be made to strengthen your home against hurricanes,
  2. provide cost estimates for making each of the recommended improvements,'
  3. rate how hurricane resistant your home is today, and how resistant it will be after improvements are made,
  4. explain what insurance discounts are available to you if improvements are made and how to get them, if you provided your insurance information.

Reason 2: A financial incentive. For qualified homeowners, the state will offer a matching grant of up to $5,000 to help pay for the cost of the hurricane-resistance improvements recommended in your inspection report.

Reason 3: A discount on insurance premiums. Homes that are strengthened with hurricane-resistant improvements are less likely to suffer serious damage in a hurricane. Homeowners who invest in strengthening their homes will be entitled to a range of discounts on their homeowners insurance premium, depending on what and how many of the recommended improvements are made. The discounts you may be eligible to receive will be outlined in your free wind inspection report. Logon to www.mysafefloridahome.com for more information.


STATE FIRE MARSHAL SINK OFFERS COLD WEATHER FIRE SAFETY INFORMATION

This week’s cold weather front has many Floridians turning up the heat in their homes. In order to help keep Floridians safe this winter, CFO and State Fire Marshal Alex Sink is offering the following information in the hopes it helps educate you and your family on fire safety.

Fire Safety Statistics

  • Forty percent of house fires start in the kitchen, over 22 percent are caused by faulty wiring, followed by careless smoking, children playing with matches or lighters, and unattended heating devices.

  • More than two-thirds of Florida's fire fatalities are age 40 and over, followed by those age 70 and over.

  • Smoke detectors are not present or are inoperative in over 52 percent of these homes.

Don't let your family or home become part of these statistics. Make time for you and your family to study the fire safety tips below and put them into practice.

Fire Safety Tips

  • Plan escape routes from every room and floor to an outdoor meeting place. Be sure everyone in the family knows and practices them. If there is only one exit from the upper floor have slides or rope ladder available and practice proper use.

  • Install smoke detectors on every floor and in hallways leading to bedrooms.

  • Change smoke alarm batteries semi-annually, easily remembered if done when changing the clocks for daylight savings time in the spring and fall months. Test alarms regularly.

  • Keep an approved fire extinguisher in the kitchen, boat and car. Be sure family members know how to use them.

  • Do not use frayed extension cords and do not place extension cords under a rug or near a heat source. Do not overload electrical outlets or extension cords.

  • Practice STOP, DROP AND ROLL with your children.


LIFE INSURANCE PLANNING
Securing Your Family's Financial Future in Case of Unexpected Death

Would your family suffer financially were you to die unexpectedly? According to research conducted for the National Association of Insurance Commissioners (NAIC), less than half of young families have life insurance for either spouse that they have purchased on their own. Because planning for life’s uncertainties will help secure a financial future for those you love, the NAIC suggests you review your insurance needs to help ensure you have the right policy for your financial situation and your family composition.

Decide How Much You Need

The first step to purchasing life insurance is to decide how much coverage you need, for how long and what you can afford to pay.

Keep in mind the major reason you buy life insurance is to cover the financial effects of an unexpected or untimely death. Life insurance also can be one of many ways to plan for the future.

Questions to ask before buying:

How much of the family income do I provide? If I were to die, how would my survivors, especially my children, get by? Does anyone else depend on me financially, such as a parent, grandparent, brother or sister?
Do I have children for whom I'd like to set aside money to finish their education in the event of my death?
How will my family pay final expenses and repay debts after my death?
Do I have family members or organizations to whom I would like to leave money?
Will there be estate taxes to pay after my death?
How will inflation affect future needs?
When considering your coverage, be sure to factor in life insurance you currently have, including group insurance where you work or veteran's insurance. Don't forget to include benefits from Social Security or survivor's benefits from a pension plan.

The Right Kind of Policy

All policies are not the same. Once you have determined how much coverage you need, it's time to find out more about the types of policies available. There are two basic types of life insurance: term insurance and cash value insurance.

Term Life Insurance
A term life insurance policy covers you for a specific number of years, or term, such as 10, 20 or 30 years. It pays a death benefit only if you die in the insured term. Term insurance generally offers the largest insurance protection for your premium dollar. A term life policy has lower premiums than a cash value poilcy of the same amount; however, it does not build up cash values that can be used in the future.

Cash Value Life Insurance
For a cash value life insurance policy, premiums are higher at the beginning than they would be for the same amount of term insurance. With a cash value life insurance policy, the part of the premium that is not used for the cost of insurance is invested by the company and builds up cash value. You may borrow against the policy's value, use the cash value to increase your income in retirement or even help pay for needs, such as a child's tuition, without canceling the policy. Cash value life insurance may be one of several types, such as whole life, universal life or variable life.

Before You Buy


After you have decided which kind of life insurance is best for you, compare similar policies from different companies to find which one is likely to give you the best value for your money. A simple comparison of the premiums is not enough. There are other things to consider. For example:

Do premiums or benefits vary from year to year?
How much do the benefits build up in the policy?
What part of the premium or benefits is not guaranteed?
What is the effect of interest on money paid and received at different times on the policy?
Remember that no one company offers the lowest cost at all ages for all kinds and amounts of insurance.
How quickly does the cash value grow? Some policies have low cash values in the early years that build quickly later on. Other policies have a more level cash value build-up. A year-by-year display of values and benefits can be helpful. Your insurance agent or company will give you a policy summary or an illustration that shows benefits and premiums for selected years. Be sure to ask questions to help ensure you fully understand the policy summary.
Are there special policy features that particularly suit your needs?
Do you understand how non-guaranteed values are determined? Ask your agent how the policy is affected by interest rate changes, changes in mortality (deaths), profits of the company, changes in the value of the investments supporting the policy, and changes in other key factors.

More Information on Life Insurance

For more information about selecting the right life insurance policy for your family, go to www.InsureUonline.org. The NAIC's free, downloadable guide to buying life insurance can be found at www.naic.org/consumer_home.htm.

Stop. Call. Confirm.

Before buying, be sure you are dealing with a reputable insurance agent and company. The NAIC recommends you STOP before signing anything or writing a check;  CONFIRM the company offering insurance is legitimate and licensed in the state.

If you have questions about companies or policies in Florida, contact the Department of Financial Services' consumer service helpline at 1-877-MyFLCFO. You may also logon to www.MyFloridaCFO.com/ for more information.


CHOOSING THE RIGHT HEALTH INSURANCE COVERAGE TO PROTECT YOUR FAMILY

If you do not have medical insurance to help pay bills, a serious injury or illness can be financially devastating to you and your family. Even if you do have health insurance, too little or the wrong kind of coverage might still mean your family could suffer under the weight of medical bills.

Right now is the best time to review your family's health insurance needs, to ensure you have the most ideal coverage to protect your family's future.

Types of health insurance that are available:

Major Medical Plans


This type of policy is usually effective in covering serious illness or injury where costs are high. Hospital care, drugs and doctors’ visits are generally covered. These benefits can be delivered in several different ways:

  • Indemnity plans – These plans usually provide the most flexibility in choosing where to receive care and typically have a deductible; i.e., the amount you pay before the insurance company begins paying benefits.
  • Preferred Provider Organization (PPO) plans – In these major medical plans, the insurance company enters into contracts with selected hospitals and doctors to furnish services at a discounted rate. As a member of a PPO, you may be able to seek care from a doctor or hospital that is not a preferred provider, but you will probably have to pay a higher deductible or co-payment.
  • Health Maintenance Organization (HMO) plans – These major medical plans usually require you to choose a primary care physician (PCP) from a list of network providers. If you need care from any network provider other than your PCP, you might have to get a referral from your PCP to see that provider. You must receive care from a network provider in order to have your claim paid through the HMO. Treatment received outside the network is usually not covered, or covered at a significantly reduced level.
  • Point of Service (POS) plans – These major medical plans are a hybrid of the PPO and HMO models. They are more flexible than HMOs, but require you to select a primary care physician (PCP). Like a PPO, you can go to an out-of-network provider and pay more of the cost.

Limited Benefit Plans

These types of policies provide limited coverage for a particular health care setting, ailment or disease. Here are some of the options that might be available to you:

Basic Hospital Expense Coverage – Covers a period of usually not less than 31 days of continuous in-hospital care and certain hospital outpatient services.

Basic Medical-Surgical Expense Coverage – Covers costs associated with a necessary surgery, including a certain number of days (usually not less than 21 days) of in-hospital care.
Hospital Confinement Indemnity Coverage – Covers a fixed amount (usually not less than $40) for each day that you are in a hospital. The benefits paid are not based on your actual expenses.

Accident Only Coverage – Covers death, dismemberment, disability or hospital and medical care caused by an accident. Specified accident coverage that covers only certain accidents may also be purchased.

Specified Disease Coverage –- Covers diagnosis and treatment of a specifically named disease or diseases; such as cancer.

Other Limited Coverage – You may purchase insurance covering only dental or vision or other specified care.
Discount Plans and Risk-Sharing Plans

Discount plans and risk-sharing plans are not insurance plans! Before signing, be sure to understand how the program works, and what benefits it offers you or your family.

Discount Plans – You might receive advertisements from plans offering discounts on health care for a monthly fee. These are not health insurance plans and participants do not have the same protections as under licensed health insurance plans. Insurance commissioners strongly recommend that you thoroughly investigate any plan promising deep discounts for a “low” monthly fee and weigh the benefits against the cost carefully.

Non-Licensed Risk-Sharing Plans – You may receive offers to join a group or association that will take your monthly payments, put them in a savings account (or trust) with other participants’ money, and then help pay some of your health care costs, as needed. Such arrangements are not insurance and the participants do not have the protections available to purchasers of licensed insurance plans.
 State insurance regulators strongly recommend that you thoroughly investigate such plans before joining.

State Consumer Protections

States provide a variety of important protections through state law. These might include:

  • The appeal of coverage decisions within the insurance company;
  • The appeal of coverage decisions to an impartial external reviewer;
  • Prompt payment of claims;
  • Access to certain specialists and health care providers;
  • Coverage of specific treatments and services.

If you have questions about protections in Florida, contact the Department of Financial Services' consumer service helpline at 1-877-MyFLCFO.

Other Important Consumer Protections

COBRA Continuation Coverage – If you purchase insurance coverage through your employer and your employer has 20 or more employees, when you leave your job, you are entitled to continuation coverage by the federal Consolidated Omnibus Budget Reconciliation Act (COBRA). Your state may also require continuation coverage to be offered by smaller employers. You can find out more about COBRA continuation of group health benefits from the federal Department of Labor, Office of Employee Benefits Security Administration Web site, www.dol.gov/ebsa/.
HIPAA - The Health Insurance Portability and Accountability Act of 1996 limits insurers’ power to deny or delay claims, reduces your chances of losing existing coverage, makes it easier and less risky to switch health plans, and prohibits insurance discrimination based on health problems. You can find out more about HIPAA from the Centers for Medicare & Medicaid Services site, www.cms.hhs.gov/.

Some Final Tips on Buying Health Insurance

Make sure you feel confident in the insurance agent and company. It is a good idea to contact your state insurance department and make sure the agent and the company you are dealing with are licensed in your state.
Learn what kinds of policies will provide what you need and pick the one best for you. Don’t hesitate to shop around and ask a lot of questions.
Do not sign an application until you review it carefully to be sure the answers are complete and accurate. Make sure that the word “insurance” is actually used and that there is no disclaimer stating that, “This product is not insurance, nor is it intended to replace insurance.”

If you have questions about companies or policies in Florida, contact the Department of Financial Services' consumer service helpline at 1-877-MyFLCFO. You may also logon to www.MyFloridaCFO.com/ for more information.


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