Posts Tagged ‘Insurance’

Automatic Premium Loan

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Automatic Premium Loan

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What Is an Automatic Premium Loan?

An automatic premium loan (APL) is an insurance policy provision that allows the insurer to deduct the amount of an outstanding premium from the value of the policy when the premium is due.

Automatic premium loan provisions are most commonly associated with cash value life insurance policies, such as whole life, and allow a policy to continue to be in force rather than lapsing due to nonpayment of the premium.

Key Takeaways

  • Automatic premium loans allow for the cash value of a permanent life insurance policy to be applied to overdue premium payments.
  • As the name implies, this would be done automatically once premium payments are a certain amount of time overdue.
  • The purpose is to avoid having a policy lapse, which would terminate coverage.
  • The payment is structured as a policy loan, and so will also require interest payments.
  • Automatic premium loans are only viable if the policy’s cash value is equal to or greater than the overdue premium amount.

Understanding Automatic Premium Loans

In order to take an automatic premium loan, you have to have a cash-value life insurance policy, in which every premium you pay adds to the cash value of the policy. Depending on the policy language, life insurance policyholders may be able to take out a loan against the cash value of their policy. This accrued cash value is a value over and above the face value of the policy and can be borrowed against by the policyholder at their discretion.

An automatic premium loan is essentially a loan taken out against the policy and does carry an interest rate. If the policyholder continues to use this method of paying the premium, it is possible that the cash value of the insurance policy will reach zero.

At this point, the policy will lapse because there is nothing left against which to take out a loan. If the policy is canceled with an outstanding loan, the amount of the loan plus any interest is deducted from the cash value of the policy before it is closed.

Note that the policy contract’s language may indicate that no loans may be taken out unless the premium has been paid in full.

Special Considerations

Since the accrued value is technically the property of the policyholder, borrowing against the cash value does not require a credit application, loan collateral, or other good faith requirements typically found in loans. The loan is taken out against the cash value of the policy, and the loan balance is deducted from the policy’s cash value if not repaid. The policyholder will owe interest on the loan, just as with a standard loan.

Automatic premium loan provisions help both the insurer and the policyholder: The insurer can continue to automatically collect periodic premiums rather than sending reminders to the policyholder, and the policyholder is able to maintain coverage even when they forget or are unable to send in a check to cover the policy premium.

The policyholder may still choose to pay the premium by the regularly scheduled due date, but if the premium is not paid within a certain number of days after the grace period, such as 60 days, the outstanding premium amount is deducted from the policy’s cash value. This prevents the policy from lapsing. If the automatic premium loan provision is used, the insurer will inform the policyholder of the transaction.

An automatic premium loan taken out against an insurance policy is still a loan and, as such, does carry an interest rate.

What Kinds of Life Insurance Policies Are Eligible to Include an Automatic Premium Loan Provision?

Automatic premium loans can only be made from permanent policies that have a cash-value component. These include whole life policies and some universal life (UL) policies. Because universal life policies deduct expenses from the cash value, they do not always allow ALP.

What Is the Automatic Premium Loan Provision Designed to Do?

Automatic premium loans are designed to keep life insurance coverage in-force even after the policy owner has not paid the required premiums on time. Perhaps the policy owner is unable to pay due to financial or other difficulties, or simply forgot. Either way, the APL provision allows the death benefit to remain even in such circumstances.

Does an Automatic Premium Loan Decrease the Death Benefit of a Policy?

Potentially. Any outstanding loans along with interest due will be deducted from the death benefit amount if the insured passes away before these are paid back.

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Affordable Care Act (ACA): What It Is, Key Features, and Updates

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Affordable Care Act (ACA): What It Is, Key Features, and Updates

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What Is the Affordable Care Act (ACA)?

The Affordable Care Act (ACA) is the comprehensive healthcare reform signed into law by then-President Barack Obama in March 2010. Formally known as the Patient Protection and Affordable Care Act and commonly referred to as Obamacare, the law includes a list of healthcare policies intended to expand access to health insurance to millions of uninsured Americans.

The law expanded Medicaid eligibility, created health insurance exchanges, mandated that Americans purchase or otherwise obtain health insurance, and prohibited insurance companies from denying coverage due to preexisting conditions.

Key Takeaways

  • The Affordable Care Act was signed into law in March 2010 and is commonly known as Obamacare.
  • The ACA was designed to extend health coverage to millions of uninsured Americans.
  • The ACA expanded Medicaid eligibility, created a Health Insurance Marketplace, and prevented insurance companies from denying coverage due to preexisting conditions.
  • The Affordable Care Act requires insurers to cover a list of essential health benefits.

Understanding the Affordable Care Act (ACA)

The ACA was designed to reform the health insurance industry and help reduce the cost of health insurance coverage for individuals who qualify. The law includes premium tax credits and cost-sharing reductions to help lower expenses for lower-income individuals and families.

The ACA requires most insurance plans, including those sold on the Health Insurance Marketplace, to cover a list of preventive services at no cost to policyholders that include checkups, patient counseling, immunizations, and numerous health screenings.

All ACA-compliant health insurance plans must cover specific “essential health benefits,” such as emergency services, family planning, maternity care, hospitalization, prescription medications, mental health services, and pediatric care.

The law allows states to extend Medicaid coverage to a wider range of people. As of September 2022, 39 states and the District of Columbia had exercised that option.

Every year, there is an open enrollment period on the Health Insurance Marketplace during which people can buy or switch insurance plans. Enrollment outside of the open season is allowed only for those whose circumstances change, such as marrying, divorcing, becoming a parent, or losing a job that provided health insurance coverage.

The Inflation Reduction Act of 2022 extends the expanded ACA for three years, through 2025, for people who need financial assistance. It also allows Medicare to negotiate the cost of prescription drugs and place an annual cap of $2,000 on the cost of drugs. The ACA extension is expected to cost an estimated $64 billion.

Key Features of the Affordable Care Act

Provisions included in the ACA expand access to insurance, increase consumer protections, emphasize prevention and wellness, improve quality and system performance, expand the health workforce, and curb rising healthcare costs.

Expand Access to Insurance

The ACA requires employers to cover their workers and provides tax credits to certain small businesses that cover specified costs of health insurance for their employees. It created state- or multistate-based insurance exchanges to help individuals and small businesses purchase insurance. 

The law expanded Medicaid coverage for low-income individuals and allows young adults to remain on parents’ policies until age 26.

Part of the ACA until 2017 was the individual mandate, a provision requiring all Americans to have healthcare coverage, either from an employer or through the ACA or another source, or face tax penalties.

Increase Consumer Insurance Protections

The ACA prohibits lifetime monetary caps on insurance coverage, limits the use of annual caps, and establishes state rate reviews for insurance premium increases. It prohibits insurance plans from excluding coverage for children with preexisting conditions and canceling or rescinding coverage.

Prevention and Wellness

The Prevention and Public Health Fund, established under the ACA, provides grants to states for prevention activities, such as disease screenings and immunizations, and the National Prevention, Health Promotion, and Public Health Council addresses tobacco use, physical inactivity, and poor nutrition.

The ACA requires insurance plans to cover preventive care such as immunizations; preventive care for children; screening for certain adults for conditions such as high blood pressure, high cholesterol, diabetes, and cancer; and a public education campaign for oral health.

Improve Health Quality and Curb Costs

The ACA requested investments in health information technology. It addressed guidelines to reduce medical errors and create payment mechanisms to improve efficiency and results and improve care coordination among providers.

The law requires oversight of health insurance premiums and practices, reducing healthcare fraud and uncompensated care to foster comparison shopping in insurance exchanges to increase competition and price transparency.

Pros and Cons of the Affordable Care Act

Pros

  • Expands healthcare availability to more citizens

  • Prevents insurers from making unreasonable rate increases

  • Individuals with preexisting health conditions cannot be denied

  • Coverage for additional screenings, immunizations, and preventive care

Cons

  • Those already insured saw an increase in premiums

  • Taxes were created to help supplement the ACA, including taxes on medical equipment and pharmaceutical sales

  • The enrollment period is limited for new enrollees

  • Many businesses curtailed employee hours to avoid providing medical insurance

Updates to the Affordable Care Act

With his election in 2016, then-President Donald Trump launched efforts to repeal and replace the ACA, stating that the United States should delay “the implementation of any provision or requirement of the [Patient Protection and Affordable Care] Act that would impose a fiscal burden on any State.”

In December 2017, the Tax Cuts and Jobs Act (TCJA) removed the penalty for individuals not having health insurance and substantially scaled back the outreach program to help Americans sign up for the ACA, cutting the enrollment period in half. By 2018, the number of Americans covered under the ACA had dropped to 13.8 million from 17.4 million in 2015, according to a report from the Kaiser Family Foundation, a healthcare research organization.

In 2021, President Biden signed an executive order to focus on the “rules and other policies that limit Americans’ access to health care,” prompting federal agencies to examine five areas, including preexisting conditions, policies undermining the Health Insurance Marketplace, enrollment roadblocks, and affordability. COVID-19 relief legislation, the American Rescue Plan Act (ARPA), extended eligibility for ACA health insurance subsidies to those buying their health coverage on the Marketplace with incomes over 400% of poverty.

With the passage of the Inflation Reduction Act, signed into law by Biden on Aug. 16, 2022, financial assistance was extended for people enrolled in the ACA through 2025 instead of 2022. It also expands eligibility, allowing more middle-class citizens to receive premium assistance. The legislation passed in both the House of Representatives and the Senate.

What are common arguments for and against the Affordable Care Act (ACA)?

Opponents argue that the Affordable Care Act (ACA) hurts small businesses that are required to provide insurance, raises healthcare costs, and creates a reliance on government services by individuals.

Proponents state that those with health insurance get medical attention quickly and live a healthier lifestyle. They contend that the healthcare system will operate more efficiently when commercial insurers and their customers do not need to fund the uninsured.

When does the yearly enrollment period on the Marketplace begin?

The Health Insurance Marketplace is available for new enrollment on Nov. 1, and information is available on the government website.

How many citizens use the Health Insurance Marketplace?

As of 2021, more than 13 million citizens are enrolled in coverage offered by the ACA’s Marketplace.

The Bottom Line

The Patient Protection and Affordable Care Act (ACA) was passed in 2010 and is commonly known as Obamacare. It extended healthcare coverage to millions of previously uninsured Americans. The ACA launched the Health Insurance Marketplace, through which eligible people may find and buy health insurance policies.

All ACA-compliant health insurance plans, including those sold through the Marketplace, must cover several essential health benefits. The ACA has continued to evolve through three presidencies.

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Aleatory Contract Definition, Use in Insurance Policies

Written by admin. Posted in A, Financial Terms Dictionary

Aleatory Contract Definition, Use in Insurance Policies

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What Is an Aleatory Contract?

An aleatory contract is an agreement whereby the parties involved do not have to perform a particular action until a specific, triggering event occurs. Events are those that cannot be controlled by either party, such as natural disasters and death. Aleatory contracts are commonly used in insurance policies. For example, the insurer does not have to pay the insured until an event, such as a fire that results in property loss. Aleatory contracts—also called aleatory insurance—are helpful because they typically help the purchaser reduce financial risk.

Key Takeaways

  • An aleatory contract is an agreement whereby the parties involved do not have to perform a particular action until a specific event occurs.
  • The trigger events aleatory contracts are those that cannot be controlled by either party, such as natural disasters or death.
  • Insurance policies use aleatory contracts whereby the insurer doesn’t have to pay the insured until an event, such as a fire resulting in property loss.

Understanding an Aleatory Contract

Aleatory contracts are historically related to gambling and appeared in Roman law as contracts related to chance events. In insurance, an aleatory contract refers to an insurance arrangement in which the payouts to the insured are unbalanced. Until the insurance policy results in a payout, the insured pays premiums without receiving anything in return besides coverage. When the payouts do occur, they can far outweigh the sum of premiums paid to the insurer. If the event does not occur, the promise outlined in the contract will not be performed.

How Aleatory Contracts Work

Risk assessment is an important factor to the party, taking a higher risk when considering entering into an aleatory contract. Life insurance policies are considered aleatory contracts, as they do not benefit the policyholder until the event itself (death) comes to pass. Only then will the policy allow the agreed amount of money or services stipulated in the aleatory contract. The death of someone is an uncertain event as no one can predict in advance with certainty that when the insured will die. However, the amount which the insured’s beneficiary will receive is certainly much more than what the insured has paid as a premium.

In certain cases, if the insured has not paid the regular premiums to keep the policy in force, the insurer is not obliged to pay the policy benefit, even though an insured has made some premium payments for the policy. In other types of insurance contracts, if the insured doesn’t die during the policy term, then nothing will be payable on maturity, such as with term life insurance.

Annuities and Aleatory Contracts

Another type of aleatory contract where each party takes on a defined level of risk exposure is an annuity. An annuity contract is an agreement between an individual investor and an insurance company whereby the investor pays a lump sum or a series of premiums to the annuity provider. In return, the contract legally binds the insurance company to pay periodic payments to the annuity holder—called the annuitant—once the annuitant reaches a certain milestone, such as retirement. However, the investor might risk losing the premiums paid into the annuity if they withdraw the money too early. On the other hand, the person might live a long life and receive payments that far exceed the original amount that was paid for the annuity.

Annuity contracts can be very helpful to investors, but they can also be extremely complex. There are various types of annuities each with its own rules that include how and when payouts are structured, fee schedules, and surrender charges—if money is withdrawn too soon.

Special Considerations

For investors who plan on leaving their retirement funds to a beneficiary, it’s important to note that the U.S. Congress passed the SECURE Act in 2019, which made rule changes to beneficiaries of retirement plans. As of 2020, non-spousal beneficiaries of retirement accounts must withdraw all of the funds in the inherited account within ten years of the owner’s death. In the past, beneficiaries could stretch out the distributions—or withdrawals—over their lifetime. The new ruling eliminates the stretch provision, which means all of the funds, including annuity contracts within the retirement account–must be withdrawn within the 10-year rule.

Also, the new law reduces the legal risks for insurance companies by limiting their liability if they fail to make annuity payments. In other words, the Act reduces the ability for the account holder to sue the annuity provider for breach of contract. It’s important that investors seek help from a financial professional to review the fine print of any aleatory contract as well as how the SECURE Act might impact their financial plan.

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All Risk Insurance: What Is All Risk Insurance, and What Does It (and Doesn’t) Cover?

Written by admin. Posted in A, Financial Terms Dictionary

What Is All Risk Insurance, and What Does It (and Doesn't) Cover?

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What Is All Risks?

“All risks” refers to a type of insurance coverage that automatically covers any risk that the contract does not explicitly omit. For example, if an “all risk” homeowner’s policy does not expressly exclude flood coverage, then the house will be covered in the event of flood damage.

This type of policy is found only in the property-casualty market.

Key Takeaways

  • All risks is a comprehensive insurance policy offered in the property-casualty market.
  • All risks and named perils are two types of insurance commonly offered to homeowners and business owners.
  • Insurance that allows for all risks means the policyholder can seek compensation for any events that the contract hasn’t directly ruled out as being covered.
  • Policyholders can usually pay more to have a rider or floater added to the contract that would cover a specific event that was ruled out.
  • All risks insurance differs from named perils insurance, in which the policyholder can only seek compensation for events that are specified in the policy.

Understanding All Risks

Insurance providers generally offer two types of property coverage for homeowners and businesses—named perils and “all risks.” A named perils insurance contract only covers the perils stipulated explicitly in the policy.

For example, an insurance contract might specify that any home loss caused by fire or vandalism will be covered. Therefore, an insured who experiences a loss or damage caused by a flood cannot file a claim to his or her insurance provider, as a flood is not named as a peril under the insurance coverage. Under a named perils policy, the burden of proof is on the insured.

An all risks insurance contract covers the insured from all perils, except the ones specifically excluded from the list. Contrary to a named perils contract, an all risks policy does not name the risks covered, but instead, names the risks not covered. In so doing, any peril not named in the exclusions list is automatically covered.

The most common types of perils excluded from “all risks” include earthquake, war, government seizure or destruction, wear and tear, infestation, pollution, nuclear hazard, and market loss. An individual or business who requires coverage for any excluded event under “all risks” may have the option to pay an additional premium, known as a rider or floater, to have the peril included in the contract.

“All risks” are also called open perils, all perils, or comprehensive insurance.

Burden of Proof

The trigger for coverage under an “all risks” policy is physical loss or damage to property. An insured must prove physical damage or loss has occurred before the burden of proof shifts to the insurer, who then has to prove that an exclusion applies to the coverage.

For example, a small business that experienced a power outage may file a claim citing physical loss. The insurance company, on the other hand, might reject the claim stating that the company experienced a loss of income from a mere loss of property use, which is not the same thing as a physical loss of property.

Special Considerations

Because “all risks” is the most comprehensive type of coverage available and protects the insured from a greater number of possible loss events, it is priced proportionately higher than other types of policies. The cost of this type of insurance should, therefore, be measured against the probability of a claim.

It is possible to have named perils and “all risks” in the same policy. For example, an insured may have a property insurance policy that has all risks coverage on the building and named perils on his personal property. Everyone should read the fine print of any insurance agreement to ensure that they understand what is excluded in the policy.

Also, just because an insurance policy is termed “all risks” does not mean that it covers “all risks” since the exclusions reduce the level of coverage that is offered. Make sure you look for the exclusions in any prospective policy.

What Is the Meaning of All Risk?

All risk is a type of insurance product that requires a risk to be explicitly stated for it to not be covered. For example, if the contract does not state “tree damage” as an omitting risk, then if a tree were to fall on the insured property under an all risk policy, since the tree was not explicitly mentioned, the damage would be covered.

What Are the 4 Major Types of Insurance?

There are insurance products for almost everything, but for most people, there are four types of insurance products that are seen more than any other. Life insurance, auto insurance, health insurance, and long-term disability insurance are those that cover most of an individual’s risk factors. Once someone owns significant property like a house or something high-value like jewelry or other collector items, they will need additional policies tailored to these individual items. However, most people who rent will own the four major types listed above.

What Are All Risk Perils?

All risk perils is another name for all risk insurance as it relates to individual risks. Named perils is an insurance product that names what is insured in case of an accident. All risks, assuming there are no perils mentioned, could be considered all risk perils since all perils are assumed as risk (under the policy). However, these are rare as they put undue risk acceptance on the insurer, and it is much more common to see many perils listed, even on an all risks policy.

The Bottom Line

All risk insurance, also called all risk coverage, is an insurance product that covers any incident that isn’t explicitly mentioned. These policies assume a good deal of risk for the insurer and are less common than named risk coverage, which states exactly what is covered, versus stating only what is to be omitted (which is the case with all risk).

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