Need Help?

Insurance is ridiculously complicated. And what saddens me is that the people who need it the most, are the ones least capable of obtaining it. Even if they can afford it, it’s just really hard to know who to turn to for answers. Hec, it’s not even easy to figure out what the questions are supposed to be.

Help Me!

Lately, I’ve been expanding my contracting in the states I’m licensed in. And that means I’ve been doing all sorts of additional training. My goal is to offer best of class healthcare coverage in every county. Life insurance is easy by comparison. It’s by state. If I’m licensed in your state, counties don’t matter. You’ll be covered. Health Insurance – that’s a different beast. First, there is the type you need. Then there is where you need it. What county do you live in? And then there is the type of network you want. Will you lose your doctor, or a much needed specialist if you change plans? Will your drugs all be covered? And what about if you have a chronic illness? What if you’re terminal? What if you’re in a nursing home? What if you are very poor and can’t afford standard healthcare?

With all these questions, you would be right if you guessed that it’s a little more complicated to provide a health plan than a life insurance policy. And to be honest, it doesn’t pay me as much. Many of my peers in the insurance business avoid it because it is a lot of work.

But I can’t do that. My inescapable reality is that I have a bleeding heart and it’s the people that need my help the most, that cry out for attention. I want to help them. The rich have more than enough helpers. The seriously infirm, the marginally qualified, those with special needs, those who might qualify for Medicaid and Special Needs Programs, those who need translators – these all need better support than they now have. And most don’t know how to ask for it. On a daily basis, I find that I’m like a sponge soaking up all I can to prepare myself to help. And be ready next time someone calls for it.

It can be distressing. Look at the lingo. According to the Centers for Medicare and Medicaid Services (CMS), those who qualify for dual special needs programs, (where they could get Medicaid and the state to pay for all or part of their Medicare expenses), are classified into the following five possible types. When I help them apply, I’ve got to classify them correctly. Tell me if this all sounds clear as mud to you.

FBDE – Full Benefit Dual Eligible only

  • Full Medicaid coverage refers to the package of services, beyond coverage for Medicare premiums and cost-sharing, that certain individuals are entitle to when they qualify under eligibility categories covered under a state’s Medicaid program. Some of these coverage groups are ones that states must cover (for example, Supplemental Security Income [SSI] beneficiares), and some are groups that states have the option to cover (for example, the “special income level” institutionalized group for individuals or home-and community-based waiver participants and “medically needy” individuals).
  • These indivudals get Medicaid only, are enrolled in Medicare Part A and/or B, and qualify for full Medicaid benefits, but not for Medicare Savings Program c ategories. However, the state may pay for their Part B premiums.
  • Beneficiaries pay no more than the amount allowed under the state’s Medicaid program for services furnished by Medicare providers.

QMB – Qualified Medicare Beneficiary Only without Other Medicaid

  • Medicaid pays Part A (if any) and Part B premiums.
  • Medicaid pays Medicare deductibles, coinsurance, and copayments for services furnished by Medicare providers for Medicare-covered items and services (even if the Medicaid State Plan payment does not fully pay these charges, the QMB is not liable for them).

QMB+ – Qualified Medicare Beneficiary Plus

  • Medicaid pays Part A (if any) and Part B premiums.
  • Medicaid pays Medicare deductibles, coinsurance and copayments for services furnished by Medicare providers for Medicare-covered items and services (even if the Medicaid State Plan payment does not fully pay these charges, the QMB is not liable for them).
  • Get “full Medicaid” coverage in addition to coverage for Medicare premiums and cost-sharing.

SLMB – Specified Low Income Medicare Beneficiary Only

  • Medicaid pays Part B premiums.

SLMB+ – Specified Low-Income Medicare Beneficiary Plus program

  • Medicaid pays Part B premiums.
  • Get full Medicaid coverage in addition to coverage for Medicare Part B premiums.

2023 & 2024 Qualified Benefit Levels & Qualifications

So what does all this mean?!

What this means and what to do about it are two different questions. What it means is some people qualify for extra help as spelled out above. Any US citizen falling on or below the poverty line is likely to qualify for state Medicaid. Even if they are as much 20% above the Federal Poverty Level (FPL), they can at least qualify to get their Medicare Part B premium covered. When people are on a low fixed income, every dollar counts.

What you can do about it is help me help people. Get them onto Medicaid, if you can. If not, see what they qualify for by helping them pay their bills. See if you can help them prove their income at their local Medicaid office.

If you’ll do that, I’ll do this

It takes a village. Having a bleeding heart is sweet, but I’m about maximizing the good I do. I know that if I spend my time tirelessly helping people get onto Medicaid and helping them with their bills, that I won’t be able to help those who have already taken those steps and now just need to get plugged into the best dual special needs plan for their needs so they can get to their doctor. Let me focus on the insurance side of the problem. Let their church friends and family help them with their Medicaid applications. Then let me know immediately what they’ve qualified for once they are approved. What is their individual or family income? Have they been approved for FBDE, QMB, QMB+, SLMB, or SLMB+? If you’re not sure which is which, call me. I can decipher bureaucracy-speak.

NOT AFFILIATED WITH OR ENDORSED BY THE GOVERNMENT OR FEDERAL MEDICARE PROGRAM.

Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 

I do not offer every plan available in your area. Currently I represent 6 organizations in Tallahassee which offer 42 plans and other organizations with numerous but not all plans in six total states, including Florida, Georgia, Texas, Arizona, California and Virginia.

My Seasons

Dual Special Needs Plans
Dual Special Needs Plans

Most of my friends know that I’m a veritable insurance mall. I handle Medicare, dual Medicaid/Medicare plans (D-SNPs), and both traditional, supplemental and Medicare Advantage plans. I also offer Marketplace (Obamacare/ACA), as well as private and specialty health plans. And if that wasn’t enough, my core business – when we’re not in a Medicare or Marketplace open season – is life insurance. I represent numerous life insurance carriers and plans so that I can match individual needs with the plan that fits best.

Use this code to schedule me

It’s January 10th. As I post this, there are only six days left of open season for the Marketplace. If you are under 65 and have significant preconditions and don’t have a very high annual income, the Marketplace may be the best match for you. You can probably avoid premiums. Just be aware that having no monthly premiums to pay does not mean you get free healthcare. And think about it. If you have preconditions, that will likely matter a lot. Always check to see what your annual deductibles will be. And count up your most likely copays and costshare. Most “free” healthcare plans only pay 70-80% and that’s only after a huge annual deductible is out of the way. Don’t get me wrong. A lot of thes out-of-pocket expenses may be subsidized, as well. But then maybe not. I’m here to help my clients figure that sort of thing out and direct them to the plans that will save them the most money.

As you might imagine, my goal is to help as many people as possible. To do that, I’ve got to manage my time super well. I’m happy to educate people, but I also like to make sure they’ve followed my advice. If I don’t have the best plans for your needs, I’ll let you know. I don’t mind that at all. What gets me down is when people end a conversation saying they want to shop around some more, and then I find out they’ve chosen a plan that will cost them more.

Life in the nursing home. Who is there to love them? Who becomes family when family leaves them?
Who becomes family when family is gone?

One thing that is particularly difficult for me emotionally is helping the seriously sick and poor with their health insurance. They are often incapable of providing the paperwork needed to prove they qualify for Medicaid or Low Income Subsidies (LIS). I will literally go the extra mile to help people who don’t know how to help themselves, sometimes driving far out of town. If a person needs Medicaid, their friends should know it. We need to be one human family and look out for one another. Managing bills when you’ve had a stroke and live alone can be near impossible. Imagine if you were alone and growing old. Who would help you? Be that friend. Step up. Let each person do what they do best. Make sure your friend has help. Bring them to your local Health and Human Services office and help them get them enrolled in Medicaid. Help them with their bills. They need you. Then once they are enrolled, they need people like me, to set them up with D-SNPs.

SOA

Qualifying for Medicaid triggers a special enrollment period for a D-SNP. That means I can help your friend outside of the normal enrollment periods most any time of year. I can work over the phone or face to face. Usually, the only limitation is that you will need to schedule at least 48 hours ahead of time using a Scope of Appointment form to schedule me once you’ve helped them enroll in Medicaid.

SOAp2

I’m sure you know your friend will also need legal representation if they can’t answer questions for themselves. Sometimes a non-family member can obtain a temporary power of attorney to help make insurance decisions on their behalf. Medical Power of Attorney, Living Wills and Advance Directives are related and sometimes critical to obtain to help people when they need it most. That said, I’m not an attorney and this is not legal advice. Downloadable forms can be obtained for free online for these purposes and you can personalize them. Then you would need to get your friend to sign them in front of a notary, but I would strongly suggest you consult with a local attorney before doing anything.

The seasons of our lives change. In the fall, I go into full Medicare mode. In the winter, I do both health and life. In spring and summer I focus on life insurance. And throughout the year I think about how I can help as many people as possible, especially those most incapable of helping themselves. Please help me help your friends. Understand that I can’t speak with you about their medical conditions or about any possible health plans without a scope of appointment that is properly authorized. And that means you may have to obtain a Power of Attorney so you can act on their behalf. If you are helping them gather the information they will need to apply for Medicaid, you will likely need a POA for that too.

  • NOT AFFILIATED WITH OR ENDORSED BY THE GOVERNMENT OR FEDERAL MEDICARE PROGRAM.
  • Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 
  • I do not offer every plan available in your area. Currently I represent 6 organizations in Tallahassee which offer 42 plans and other organizations with numerous but not all plans in six total states, including Florida, Georgia, Texas, Arizona, California and Virginia.

What is Holistic Insurance?

You are problably aware by now that as an independent insurance consultant, I am like a virtual insurance mall. While I don’t have contracts with every carrier, I am licensed in multiple states to produce not just Medicare of every type, but also Obamacare for those under 65 and private insurance, as well. And I have more options for life insurance than most other agents too – more carriers, more products, more variety, sorting from among 95 top rated carriers based on your personal qualifications.

But do Insurance Malls offer shopping assistants?

The problem with the insurance mall concept is that it suggests casual browsing. If you treat shopping for insurance casually, then you are taking the wrong approach. You should be diligent and make a good decision. Good decisions can save you thousands of dollars. Bad decisions can cost you tens of thousands of dollars. All this affects those you love.

Also, in a mall, there is no consultant to guide you through a mass of complex options so that you can make the right decision about something you could need immediately and just don’t know it yet. What you need is an experienced coach. As I see it, my job is to encourage you to take the world of insurance seriously. There is nothing that affects your pocket book more dramatically than lack of adequate health or life insurance when you or your family needs it.

Being Over-Insured

You could have an accident tomorrow. You, or a loved one could have a stroke. Bad things happen to seemingly healthy people all the time and you never know when. I don’t have to tell you this or you wouldn’t be here reading about it. But don’t let such facts frighten you into buying more insurance than you need. You are buying too much insurance if you are unlikely to be able to make the premium payments. That part is obvious. But you are also buying too much insurance if the odds of you ever needing it are exceedingly poor, or if the same insurance would be included in another type of policy. You don’t want overlap. Third, you may be paying too much and probably are, plain and simple. Why pay more money for less insurance? Usually, the problem is being under-insured, of course, and then finding this out too late. Many, for instance, rely on their employer’s insurance, or their VA benefits, only to discover that their coverage has limitations. I strongly advise that you take the time to have me review your policies.

What To Expect From Me?

Are you in an enrollment season?
Scan or click here to Get Medicare

I take a holistic and realistic approach as I help you shop for insurance. I leave my teaching to my blog. I assume you don’t have unlimited time to research this. So I will simply explain why one product is better suited for you than another and give you a recommendation based on your personal needs and qualifications. My goal is to get you set-up with an insurance plan effortlessly and without delay once we’ve identified the right products you need and searched for the best price. As always, insurance is highly regulated.

Scan here to Get Obamacare in Season

On the health side, there are only certain times of the year you can make changes. I’ll let you know when those are. For Medicare, you will need to complete a Scope of Appointment form to even talk to me about specific plans and there will be a 48 hour minimum delay before the appointment. That’s the law. For Marketplace products (Obamacare, AKA ACA), you’ll need to grant me permission to contact you.

Of course, I won’t contact anyone who hasn’t asked for help anyway. Same for life. If I call you, it is because you asked me to. I only ask that you keep your appointments and have the documents you will need on hand.

What Documents Do You Need?

In almost every case, you can expect simplified underwriting and instant approvals. The carriers I choose generally don’t require medical appointments. Instead they utilize information from the Medical Information Bureau (MIB) under HIPAA.

LIFE INSURANCE DOCS YOU’LL NEED TO HAVE ON HAND

  1. Drivers License or proof of identity
  2. List of Medications insured takes, dosages, how long taken
  3. Names, Addresses, Phone Numbers of all proposed insured and their beneficiaries.
  4. A good email address of the policy owner.
  5. Policy owner’s social security number.
  6. Bank Routing Number and Account Number to draw premiums from

HEALTH INSURANCE DOCS YOU’LL NEED TO HAVE ON HAND

  1. Same as for Life (see above) except list of meds and beneficiary info aren’t needed
  2. Medicare card if applicable
  3. Name and address of Primary Care Physician if you have a preference
  4. Name and address of any specialists you want to keep
  5. Current Policy Info. (Carrier names, plan details)
  6. List of drugs you want to see the prices of. (You don’t have to volunteer any medical information when applying for Obamacare or Medicare but it is often helpful when comparing plans)

What is Private Health Insurance?

In general, you will save money with private insurance and get the same or greater benefits if you qualify. On the downside, with private insurance you won’t get tax credits and cost sharing help from the ACA state or federally facilitated marketplace and you may not qualify if you have pre-existing conditions. On the positive side, you don’t have to pay for other people’s pre-existing conditions or subsidize their healthcare costs and this saves all of the members money. Generally, it is best suited for those who earn too much to qualify for significant tax credits in the marketplace and who don’t have significant pre-existing health conditions. Not everyone qualifies.

Most ancillary plans are also private. Ancillary plans cover serious conditions like cancer, heart attack and stroke on the one hand, and dental, hearing and vision, on the other. Many plans also offer network discounts and other benefits for things such as lab work, imaging and genetic analysis. Most private plans include medical appointments and counseling online or over the phone with little or no extra cost. Some private plans also specialize in short term medical and in-home care, which is not covered by traditional plans.

What is a Holistic Approach?

A holistic approach to life and health insurance looks at goals and budgets. It analyzes gaps in coverage and counts the cost of filling them and the risk of not filling them. Many people are surprised when they find they have been paying huge premiums only to encounter budget busting deductibles that prevent plans from paying the first benefit when a health crisis comes along. A holistic approach is educational. It is not enough to be insured. A person should know what is not insured and what risks they are taking and what the consequences of being under-insured can be. An independent insurance agent is your friend and guide. It is their job to keep you informed and adequately and appropriately insured. Many plans also offer incentives and benefits for going to the gym or for planning a healthy diet and for going in for regular check ups. An ounce of prevention is worth a pound of cure. Some plans also offer over the counter drug benefits, allowing you to purchase vitamins and other non-prescription drugs. As your guide, it is my job to help you weigh out these options. Sometimes a traditional plan saves you more money than a plan with lots of perks. If I can get you to fully understand what the trade offs are without overwhelming you with too much information, I’ve done my job well.

A holistic approach also considers your whole family. It helps you plan long term and considers your final expenses and legacy. On account of marketing regulations in the health insurance business, I generally start a discussion about life insurance first. I am not permitted by law to cross-sell life insurance to my Medicare clients. But my aim in producing life insurance is to help families keep homes, protect inheritances and build savings. Instruments like Indexed Universal Life insurance policies build wealth that can be transferred to loved ones at death without inheritance tax and free from creditors. Annuities and IULs can both be indexed to S&P etc. for more earnings than banks, yet guarantee against loss. Some offer living benefits. This means that if a chronic or terminal illness occurs, a life insurance policy can cover what a health insurance policy doesn’t. Life and health insurance are related through living and accelerated benefits. So, typically a conversation about life insurance will lead to a conversation about health insurance and savings plans.

Ultimately then, I’m simply your insurance guy. I don’t offer everything. Who does? No property and casualty insurance here, for instance. But I can offer group health and life, or individual and family health and life, as well. I’m very versatile. And if you’ve got a 401K, I can even show you how to convert it into an annuity that won’t be subject to market losses. Very cool. Like I said, I’m a virtual insurance mall. Just don’t be so casual. And don’t be too proud to ask for a guide. Everyone needs help. And very few people understand what being under-insured actually means.

Caviat:

  • NOT AFFILIATED WITH OR ENDORSED BY THE GOVERNMENT OR FEDERAL MEDICARE PROGRAM.
  • Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 
  • I do not offer every plan available in your area. Currently I represent 6 organizations in Tallahassee which offer 42 Medicare plans and other organizations with numerous but not all plans in six total states, including Florida, Georgia, Texas, Arizona, California and Virginia.

What is Ambulatory Surgery?

Let’s DisAMBiguate Ambulatory Surgery

Does insurance and medical terminology confuse you? I have a dirty little secret. It even confuses licensed professionals. The word ambulatory sounds like the word “ambulance.” So what is ambulatory surgery and what is an ambulatory surgery center (ASC)?

As it turns out, it has nothing to do with ambulances.

ambulatory-surgery-centers-brochure

In short, ASCs save money because if you need surgery, you can simply get a provider or specialist to schedule you. ASCs skirt expensive hospital check-ins.

Typically, you go home after an ambulatory surgery. You save money by not spending the night. Does that remind you of something called “outpatient surgery?” It should. So, what’s the difference between “ambulatory surgery” and “outpatient surgery”?

Very simple. Ambulatory surgery is a type of outpatient surgery that doesn’t involve a hospital. It only involves an Ambulatory Surgical Center. And that will likely save you money.

Ambulatory Surgical Centers may say “Outpatient Surgery”

That said, be careful. On the downside, there could be complications a hospital could be better suited to deal with. For instance, an ASC may not know about all of your medications and allergies. It also may not be prepared to tackle any complications that its streamlined business model, designed to save money, is designed for.

Think speed and efficiency, but don’t let that confuse you. Despite the name, you may or may not need to take an actual ambulance to make your appointment to an ASC – more likely not.

Emergency transportation in an “ambulance” is another matter. What does your plan say about that? Let’s look up all of these possible costs together, measure risks and find a plan or combination of plans that works best for you. That’s what I do.

James Carvin is a Florida based insurance consultant licensed in multiple states.

In case you missed it …

Are you on Medicare? Do you have Part B?

It may seem like a silly time to ask that question. The annual enrollment period just ended December 7th. But getting insured doesn’t always require waiting for an annual enrollment period. In today’s blog, I’ll summarize the exceptions…

#1 – If you are under 65 and healthy, Medicare is probably not what you want. What you want is Obamacare. Obamacare goes by a few other names – ACA, Marketplace, FFM. Don’t be confused. I’m here to make it all easier to understand. There is an open enrollment period for the Federally Facilitated Marketplace (FFM), (or your state marketplace, if you are in a state with a state FFM equivalent). For most people, it’s understood as Obamacare. But what’s in a name? Bottom line: your enrollment period ends January 15th. Call me. I’ll show you your options.

#2 – Some insurance products don’t have enrollment periods. For instance, odds are you can sign up for an indemnity plan any time of the year. You can also add on or remove dental, health and vision, or cancer, heart attack and stroke policies to your existing insurance. Obamacare and Medicare plans don’t normally cover these. You can also initiate a Health Matching Account at any time up to age 64 without respect to enrollment periods.

#3 – You may qualify for Medicaid. And if you qualify for both Medicaid and Medicare, you may be eligible for a Dual Special Needs Plan (D-SNP) with a Dual Special Enrollment Period (D-SEP). I have a heart for people in need. And the good news is that those who qualify, can enroll or change plans once every three months – except in the fall. But that’s when the Annual Enrollment Period (AEP) happens (Oct. 15th-Dec 7th), so even in the fourth quarter you can get enrolled or change plans if you are a Medicaid recipient who qualifies for Medicare.

#4 – Whether it’s Obamacare, or Medicare, if you move in or out of a service area, you’ll probably qualify for a special enrollment period (SEP). In fact, if you don’t change plans, carriers will boot you off your plan after you’ve been out of the area for six months. Don’t let this catch you off guard. Go ahead and change plans before or after your move. Ideally, you’ll remember to set an effective date for a health plan change a few months in advance as you are packing. I love getting calls from people moving to Tallahassee. I’m happy to be their tour guide.

#5 – You also qualify for a Special Enrollment Period if your plan gets terminated. Moving can do that. So can non-payment. Don’t let your policy lapse! Other reasons might involve fraud or duplicate coverage. Maybe your plan’s carrier went out of business. Or on a more positive note – if you were on a special needs plan for a chronic condition that you no longer qualify for, or because your icnome improved and you no longer qualify for a Dual Special Needs Plan. Whatever the reason, the good news is you may not have to wait until next year to get insurance.

#6 – Thinking even more positively, there’s also the possibility that a plan earned five stars. A plan earns five stars when it doesn’t get bad reports from enrollees. Companies that get compliments instead of complaints through the Center for Medicare and Medicaid toll free number get rated accordingly. When a company earns five stars, everyone in the network area has the option to immediately switch to that plan, or do so any time before the next annual enrollment period. Cool? Believe it or not, there is actually some incentive for these networks to meet or exceed your expectations. I should also disclose that part of that formula is agents like me. If I tell you about a plan, I want to make sure you get out of it what you are hoping for. Good communication is critical. Complaints stem from poor communication. Never rush when enrolling in health care. Learning about it can be a tedious process. There are too many choices. I’ve learned that good communication and consumer education is an art. It may be faster to just say, “trust me.” I can get people in and out of the door quickly if I have to. But medical costs and processes have harsh realities. I’ve done my job well if I’ve prepared you to know what to expect. Take time for quality decision making. Five stars.

#7 – Dramatic changes in your health or income may also qualify you to change plans outside of the annual enrollment period. This can be an improvment from a chronic or qualifying condition that triggers the loss of a plan as noted above (#5), or it can be a loss of health that qualifies you for a chronic special needs plan (C-SNP). There is also going into or coming out of institutions such as nursing facilities. This will trigger a thirty day period to change a plan under an I-SNP (SEPI). Don’t worry about the jargon and the acronyms. Just call me and I’ll give you more specifics.

#8 – Federally Declared Emergencies and Disaster Areas can trigger special enrollment periods. In Florida, we had Hurricane Idalia. This SEP declaration is effective: 08/27/2023 – 01/31/2024. All counties in the state qualify.

#9 – When we are talking about Medicare, there is always a bit of confusion about the difference between an Intital Eligibility Period (IEP) and an Intial Coverage Enrollment Period (ICEP). This relates to when a person actually enrolls in or qualifies for and takes advantage of Medicare for the first time as opposed to when they become eligible. A person becomes eligible three months before their 65th birthday to sign up for Medicare. This is the Initial Eligibility Period (IEP). It lasts until the end of the third month after their birthday and it comes in two possible parts – Part A and Part B. Part A is automatic and free when you request it from Social Security at https://ssa.gov.


Part B is optional and some people delay paying it because the premium is pretty significant. You may be penalized if you don’t pay it. You may have an equivalent from your employer’s group health plan. If you do, you won’t be penalized. The catch is that you still have to pay for Part B if you want a Medicare Advantage plan. And there are certain advantages to Advantage plans, but today we’re just talking about special enrollment periods, and the ICEP isn’t exactly a Special Enrollment Period (SEP). It’s standard. But both the IEP and the ICEP periods give certain qualifying individuals time outside of Annual Enrollment Period Oct. 15th – Dec. 7th, to enroll in or change Medicare plans. And that’s my summary of special enrollment periods.

#10 – When you do things matters. You can call me any time and ask for help. You can get all this same information at Medicare.gov and/or at CMS.gov. HealthCare.gov focuses mainly on Obamacare and the Marketplace or FFM. I am here to guide you through it all. Two other periods deserve special mention. For Medicare, there is an Open Enrollment Period (OEP) from Jan. 1st – March 31st. The Medicare Advantage Open Enrollment Period is for those on Medicare Advantage Plans. Whereas during Annual Enrollment period those qualified can make as many changes as they want until the period ends, Medicare recipients can make only one change during the Medicare Advantage OEP period. They can go back to traditional Medicare if they want. Or they can switch Medicare Advantage plans. If they go back to traditional Medicare, they can add a stand alone drug plan. The purpose of this period is to help people make adjustments when they’ve chosen plans they realize don’t really meet their needs.

The second special period is for Obamacare. This is the regular Open Enrollment Period for the Marketplace that begins November 1st and lasts until January 15th. We are now in that period. In my last blog, I described the various health care buckets. It is not always in a person’s best interset to be on a Marketplace plan. Private plans that don’t qualify for the Marketplace may be both less expensive and even cover more, depending on the plan. I already covered this a few blogs ago so I won’t repeat that here. Today, I just wanted to be clear about when to take action. In December and early January, I’ll be focusing my attention on the young and the relatively healthy since its open season. I do have contracts with a number of Maretplace carriers and plans, not all. But I also know most people want to save money. Call me and I’ll show you your options.

James Carvin Insurance business card. Medicare, ACA Life Insurance
James Carvin insurance. Virtual or in home appointments in multiple states

Open Season

As the 2023 Medicare Annual Enrollment Period (AEP) comes to a close (December 7th), I’ll be shifting my focus from Medicare to Marketplace and Group Health Plans from now through January 15th. Tis the season. If you happen to find out you don’t like a Medicare Advantage plan that you just got on, an adjustment to your Medicare Advantage plan, either from one to another, or back to traditional Medicare may be made January 1st through March 31st.

If health insurance confuses you, here is a quick summary. There are three basic types:

Medicare: Generally those 65 years old or more who qualify for social security or social security disability. Also those with ALS and End Stage Renal disease. To set up an appointment to get onto or switch Medicare plans near Tallahassee, call 850-270-2642. Elsewhere, dial 833-485-0194.

Marketplace: Generally the Marketplace is for adults 21 and up who don’t qualify for Medicare and don’t have Group Health Insurance. The Health Insurance Marketplace is also referred to as Obamacare and ACA, which stands for the Affordable Care Act. The ACA Marketplace is designed for those with low income and/or pre-existing conditions. Others not on Medicare should probably try Private Insurance to save money. Under 65 and don’t qualify for Medicare? Compare Marketplace plans here.

Private Insurance: Private Insurance is generally the best option for those who don’t qualify for Medicare and who don’t have Group Health, who have to pay too much for Obamacare because they earn too much and also don’t have pre-existing conditions. Paying too much for Obamacare? To schedule a consultation, dial 850-270-2642.

Outside the Buckets

In addition to the main categories above, there are certain special situations.

SNPs: If you’re on Medicare and also close to or below the federal poverty line, you may qualify for extra help, either through a Low Income Subsidy program (LIS), or state Medicaid. If you are both on Medaid and Medicare, then you qualify for a Dual Special Needs Program (DSNP). If you need free healthcare, DSNPs are one way to get it. There are also other types of SNPs, such as Institutional and Chronic Illness SNPs. If you qualify for an SNP of any type, there will typically be a Special Enrollment Period corresponding to it, which you should ask me about. If you know of someone going into or coming out of an institution such as a nursing or rehab facility, direct them to a licensed agent like me to see whether an adjustment to their plan makes sense.

Specialty Plans: There are some types of plans you can enroll in all year long. They don’t have enrollment periods. As an example, insurance for cancer, heart attack and stroke, for short term home health care, for long term care, for dental, vision and hearing, for health matching accounts and life insurance policies mostly don’t have enrollment periods. You can ask me about this type of insurance any time of year. I’ll help you compare plans and options you qualify for. Call 850-270-2642.

James Carvin Insurance business card. Medicare, ACA Life Insurance
James Carvin insurance. Virtual or in home appointments in multiple states

Specializing in Hard Cases

I have noticed that the people who need insurance the most are commonly the people who are least able to afford it and unable to help themselves. This saddens me because I like to fix things for people. Very poor people, the elderly and the infirm can be hard to help. Many don’t have the same level of digital access. I have to meet with people several times and not everyone is capable of understanding everything that is at stake. It isn’t profitable to serve hard cases. It takes more time. Policies that require premiums often get canceled for non-payment and insufficient funds. People often make poor decisions.

My goal in the coming years will be to create an agency that specializes in handling hard cases and simplifying the complex for those in need. No one should be left behind. I hope to build an army of highly educated specialists for this purpose. If you would like to take part, I will be happy to train you. You have my number.

Thanksgiving Thoughts

Many people suffer during the holidays. It is an exceedingly busy time of the year and many of our years are filled in preparation. We measure our goals annually. We compare this year with the last and see what hope we have for what remains. We reflect on our lives. No wonder Halloween seems to kick it all off. It can be a nightmare. Maybe that’s why my whole body broke down last week and today on Thanksgiving I’m still recovering. The stress of it all can be overwhelming. But I’m thankful for that sickness. While it spelled out complete failure in achieving my goals, since I was laid up in bed, it also gave me time to reflect and find a quiet place in the midst of the struggle. I needed to adjust the timing of my vision.

James Carvin
It’s Thanksgiving! Let’s think happy thoughts and express our gratitude! Oh, what’s that on my tooth?

Timing is seldom as we would have it. I have learned that the hard way many times. Then when the age of sixty five approached, it pushed itself onto my vision again, only to humble me, once more. So as if to ad to my nausium (sic), as the holidays approach, rather than being the Santa Claus that can help everyone I would like to help this year, I find myself fortunate to have a roof over my head, and food for my growing family, just barely making it. Here on Thanksgiving Day, with fifteen minutes I’ve set aside to express my thoughts – stretched by typos and editing much longer, I’m reminded by the occasion that I am indeed grateful for the Living God, who speaks to me despite my poor listening ability, even if it requires removing my health for the sake of slowing me down and finding that quiet place.

For many of us, myself included, the happy memory of youthful Thanksgivings gathered around large families, breaking out the leaves on the dinner table, enjoying parlor games, and if like me being able to swim and go to the beach without being cold because we’re from Florida’s paradise, and as children, having few cares in the world, we think to ourselves, “how can any Thanksgiving ever be like that again?” Most of the people we loved are gone, and certainly that carefree life is gone. We are the providers now, and we are not doing the best job of it. Family fortunes are lost. It’s up to us now to bring about good endings to our lives. Entering the senior years we consider what we can do with our remaining days to make the best of them. Some of us have more work to do than others. Some have achieved their dreams and have provided their children with the great experiences we had when we were young. If that’s you, I’m super glad for you. It’s exactly what I would hope for myself and for anyone.

My sincere wish for you and your family this year

Others grew up under-privileged. For these, I have a dream they will know one day what Thanksgivings like that can be like. Some have. Not enough. Never enough. I wish we all had that. Don’t you? We all have that opium of the people called religion to offer what the world fails to. That’s what I’d think if I’d lost my faith anyway. I’m among that 1% of philosphy post-graduates who is still a theist. Academia is misguided. I am here to show them their error – the details of which belong in some other blog. Today, I share my Thanksgiving Day thoughts. I am at a particular place in a particular way. I caught a very bad flu bug a few weeks ago that I still haven’t shaken. My head still sounds stuffy. I’m still in bed quarantining myself as best as I can from my wife and children.

This couldn’t have happened at a worse time. I was supposed to be on the phones. I was supposed to be in pharmacies helping people during the Medicare Annual Enrollment Period. A person with an active virus and a conscience doesn’t do that. Change of plan.

I did test negative for COVID. For that I’m grateful.

So, this is what I heard from God in my quiet time about it all. Next year is another year. You can do what you can. If I had been designed to be a natural born salesman, I would be wealthy right now. I am not a salesman. I am an educator. I am a visionary. I design things. I see what the future could be like. I try to spell it out for others to work together to achieve. We each have our gifts and our role and our calling. Should I be insulted by the successful salesmen in my life, or the otherwise well-to-do who think I lack what it takes to succeed? Should I feel looked down upon? Should they feel superior to me? Should I feel inferior to them?

No, not at all. If they want to look down on me, that’s their life. I won’t judge it. But in my quiet time, I came to terms with what matters to me at the core of who I am and affirmed the sense of purpose I’ve had growing inside myself from my youth. I know now more certainly than I ever have that I’d rather be poor than sacrifice my convictions. I may make a living by commissions, but I am not and will not become a salesperson. I will be a visionary and an educator. I will be a consultant.

For me, my eye is on sales only for the sake of service; credit PostMedia

Salespeople annoy me. They tell me what I want to hear so they can keep my attention until I give them what they want – my money. They annoy me endlessly with phone calls and advertisements that clog up my time, my voicemail, my inboxes. They disrupt coversations and the work I’m doing. They hire telemarketers who ruin peoples’ lives and take their money. I have to pay money to remove the interruption of their ads. I’m on a budget. But they won’t leave me alone. They think they’re better than me because they make money doing that while I resist selling things to people I woudn’t sell to myself if I were them. They justify it in their minds as what needs to be done to succeed in this world because it’s the only thing that works.

Sadly they are right. Still, they dismiss the fact that I have a conscience and won’t hurt anyone else to earn my money. I just can’t. Even if they want me to call, most don’t want me to call. If they really want what I’ve got, they’ll get on the phone and get it taken care of. They’ve probably already taken care of it or they would have called me back, typically within a day, if they haven’t come across something that gave them second thoughts already and changed their mind. I know this because they tell me. So I’ve learned that the odds are I’m disturbing someone even if I’m just following up on business they initiated. To a successful saleman, this is a form of weakness on my part – maybe some rationalization or excuse to avoid rejection. I can squeeze a lot more out of my leads if I’ll just imitate what they do. Others may suggest I’ve self sabotaged my success by resisting their sound advice. But that’s not true. I do press back and override that fear and I definitely do my follow up where a professional standard ought to be set. It’s courteous. It’s expected. It’s right -both to them and to myself. But there is a gray area. And in that area the phone gets harder to pick up, or easier if its on my side of the gray. But I don’t like their level of use of the phone.

How much phone is too much phone? Credit: Tulsa World

They want me to call twice in a row, or three times. That way the prospect senses urgency. They want me to do this three times daily for each lead – morning afternoon and evening. Can’t miss that way. They want me to keep calling for months. They want me to use an autodialer, plus texts. Its all a numbers game. They’ve even suggested I buy years old fifty cent leads and bragged about how that’s how they got their start.

Hell to the no. I hated the phone long before this. I hated the phone for the simple reason that it isn’t asynchronous. I personally hate getting calls at the wrong moment and hate playing phone tag. Emails and texts are read at the receivers’ convenience. They don’t even have to think of how to politely hang up if they’re not interested. And they can unsubscribe, which reduces my costs and their future hassles. But with phones, the National Do Not Call Registry is almost useless. Robo programs to detect and deal with spam and scam calls are yet another waste of money. They don’t work.

But it’s not just the phones. It’s personality types. Learn them. Build your corporate culture around them. What do you want your company to be? What does your conscience tell you?

Discern your balance

I should be clear about this. Empathy is not absent but different for a salesman than it is for an actual empathic consultant. A salesman will pick up on others’ feelings only to use them for their own ends. I pick up on how people feel because out of natural instinct I ask, “what if that was me?” We both have feelings. Salemen have feelings. The difference is the way our conscience works. Consultants don’t like using people.

Some people also think that successful salesmen all have alpha personalities. They will win at all costs. This is an unfair characterization. I actually respect most alpha types. They have an energy and a charisma that keeps on going like the Energizer Bunny. Not all successful salespeople are alphas. Many are. In truth, to be a successful salesperson, all you have to do is follow the rules and the scripts. It’s a numbers game. A good script and a good system can make success inevitable and for an alpha. Any path to success is a winning path, so many successful salespeople are alphas. Simple. A consultant at heart, by contrast, may take moral issue with the system itself and avoid or alter it. That probably won’t stop an alpha. Recruiters, just choose the corporate culture you want. Hire at least a few genuine empaths if you’re interested in building a better system.

So to be clear, its not alphas but pushy salespeople that are the problem. For me, I would rather fix problems than be a part of them. Yet, I’m forced into the irony that it takes money to make money. And that is yet one more problem in this world I would seek a solution for if I could. I do have a knack for designing systems. Don’t misunderstand. I don’t reinvent wheels. Wheels work. I only reinvent wheels claiming to be wheels when they don’t work. I fix flats. And I value the sprocket of innovation. I sew them to my top hats because I get passionate about creating high impact change – seeking to fix only things I believe are broken, things that nag me by their pain for attention. It’s a heck of a thing to think about when you are in your bed high on Nyquil for weeks at a time. Does it really have to be true that it must take money to make money?

Oh, I wish you knew how I’ve thought about that problem.

All of this is to say, don’t be surprised if you find messages from me in your email. This is known as drip marketing. It’s nothing personal. It’s just that I can balance my principles. You may find me dressing up my ads with entertainment. You may find me exceptionally courteous. You may get some thoughtful but obviously mass emailed holiday notes and reminders in the least pushy ways, that you must excuse because such niceties have become expected business courtesy among the highly capitalized, with whom I’m expected to compete. And in the years to come, you may see the JamesCarvin.com web site morph into an insurance educator’s paradise. That’s my goal. If you want to know anything about insurance, JamesCarvin.com will be the place to find out about it, whether you are a sales professional, or a prospective client.

Truthfully, I’ve never sent a card that didn’t express how I actually felt.

That’s all fair game. I may even call. This is the line between push and pull marketing. I prefer to be contacted because you got engaged in a subject I was writing about. You asked me questions. That is pull. That is the world I would want to live in. And I won’t fail to call you when I myself would want to be called in the same situation it sounds like you’re in. Allow me to live the future I want if I can. So, I dream of ways. I clear my sinuses. I dream some more. I pray more.

I’ve been very general about the difference between salespeople and genuine consultants. If you’ve kept up with me, you know that I recently got another college degree and that I have now started an insurance business. Since then I have sold quite a bit of insurance to people, thinking about what I would personally want and need. I consider this all a continuing education. Unfortunately, I’ve come to tangibly realize through actual contact with the public that the people who need insurance the most are the people who can least afford it. There is a learning curve involved in continuing education like this and no one gets credit for it. But being wired as I am, when encountering snags and SNAFUs, I continue going to great lengths to find solutions to hard problems I’m personally running into. This tendency has proven to be the downfall of many an entrepreneur. I realize I’ll have to choose my battles wisely.

Still, I get frustrated when I can’t help people who ask me for help. Your problem is always my problem. That’s not how a salesman thinks. A salesman doesn’t have time for problems. They are in this for themselves. The only problem you have they care about is the one that profits them. You won’t hear a downside too often, if there is one. Maybe you’re lazy or just lack time. What you want is a recommendation and to get it done. Or, you’ve already made up your mind. You’re not asking for information. You just want to get your contracts set up so you can get to your next chore. Your lack of time to invest in solving this problem is understandable. A consultant and an educator doesn’t want to waste your time or theirs either. A medical doctor has his or her next appointments, as well. You don’t have to listen to their advice but you can bet they wish you would. If you don’t trust them, then change doctors if you can. Let me check your insurance and youre network. A true consultant just want to make sure they’ve really solved your problem. And in fact, if what you want isn’t in your best interest, then it’s in our best interest to slow you down and ask if you’ve got a moment to rethink it. Maybe we should even step in and sell you what you need rather than what you want. We ideally have a good diagnosis, prognosis and treatment plan. Let us earn your trust. And at times, let us be pushy.

Courtesy: The Assent. Read full article here.
All of the above are true statements. How pushy do you think I should be about this?
The main point I’d add is to just make sure you can make the payments and you have the right policy.
How do you know? Ask me. I can also help with health insurance questions. Let me earn your trust.

As I roll around in my bed in the middle of the night, high on Nyquil, my thoughts are on pushy salesmen. That’s funny. Who’d a thunk it?

But it’s relevant. I may be predisposed to hate pushiness, but that doesn’t mean I won’t push you into a decision when I know it’s in your interest to make one, if you’ll allow me. I may even seem forceful. One too many times I’ve lost a sale, only to find out someone chose a product that was to their detriment. It compares to knowing your child is about to step out into traffic. There is a time you must take command. Force a sale. Sternly warn and admonish. There is a time to say to someone, “don’t think about this.” Sign up now. Adjust later. We lose prospects way too often who say, “I’ll think about it.” What are you thinking about? My consulting gave you your best answers because I cared about you. I know my competitors. I could have contracted with them if I had wanted to. Did you hear me when I told you this?

One too many times I’ve made the mistake of setting up another appointment only to hear my client chose another company with another product. Even when my appointment was in home, face to face, they’ve done this. They respond to the first ad they see as soon as I leave, having given them something to think about. That’s a rookie mistake. Not only have I walked away from money but people hurt themselves and make bad choices just because I let them. It’s irresponsible of me to be so polite. Within 24 hours of my stepping out the door without a contract, they’ll call a salesperson instead of a consultant.

Courtesy: Katie from Tattoodo. Find Katie here.
Wolves in sheep’s clothing do their best to stay hidden. Learn to discern.

They won’t know this though. Salespeople are trained to sound like consultants when they aren’t wired by God to be consultants. They are slick. They withhold information they know could be a deal breaker. And they sometimes lie. Learn to discern. Calling a trusted name makes no difference. Think about it. Long standing brands hire salespeople. They teach consulting to their salespeople but they don’t hire empaths because true empaths won’t work for them unless they have the right products. They work for their shareholders. Their volume isn’t built on better products. It is built on a thirstier sales force. I won’t say trusted brands can never be trusted. I have contracts with many of them. But I wouldn’t recommend you go to them directly. They can only sell you their own products. And they are very good at doing that.

For a true consultant, this matters. They will be independent and build their business much more slowly than average in order to contract with all the right suppliers. They will rarely be held captive as an employee of one company because that will not likely be in the best interest of the majority of the people they would like to help. People don’t just lose money and benefits when they make inferior buying decisions. They don’t just pay too much for policies that way; they hurt their families. If I care about that, I need to be pushier sometimes. I also need to take more time and emphasize the importance of doing what I’m asking. It may be in a client’s best interest to let me save our time by directing a conversation. I might even run the risk of being a sheep in wolves clothing, but I’ll be honest and direct with you about it. Still, I don’t want to deprive you of the quality time you really do need.

Courtesy: Slide Geeks – See full presentation here.
Step 6 can be avoided for most policies below $300K face value through Simplified Underwriting but requires a medical check similar to a credit check through the Medical Information Bureau (MIB).

The family that gave me a raw lesson on taking more time, was a life policy. The woman used her thirty day think about it period to shop other companies. I educated her before and after the sale, but didn’t think to warn her not to continue shopping around since I had already checked and knew she had the best policy she could qualify for. I’d spent more than the average amount of time the field marketing organization I was working with recommended but I should have ignored them. She went and got a cheaper quote over the phone as soon as I left – and it was even a company I represent, probably my favorite insurance carrier, in fact.

Tragically, the only way she could get contracted was by lying on her application over the phone, avoiding the disclosure of the specific info I had just asked her and she had disclosed to me. She was declined on that policy but not before canceling the good policy that I had just written for her, thinking she had cleverly scammed the system. She hadn’t paid attention to the fact that I had just told her that the underwriters were going to look at those meds and decline her app using a background check, so being honest was essential. She failed to trust me. I should have repeated myself. This is no made up story. She died from a fall in her home just two days after she cancelled the lower face value policy I produced for her. She listened to her friends, who said she could buy more for less because they could instead of me. I should have taken extra time to warn her and explain why she should trust my word over her friends, why should think of me like a doctor. My license came with much study and my experience has value too. I should have repeated myself. I should have gone out of my comfort zone and warned her not to be dishonest. I could have found a delicate way to say it. This was a poor woman. It cost her children their entire would-have-been-tax-free inheritance. I felt that family’s loss very deeply.

James Carvin Insurance business card. Medicare, ACA Life Insurance
James Carvin insurance. Virtual or in home appointments in multiple states

It’s tempting to give more examples of why being pushier can make sense. This is what experience teaches. But I’m still not a salesman. This is consulting. Consulting can seem like pushy sales. Pushy sales can seem like consulting. When you are with me, you are consulting someone who really doesn’t want you to suffer, really treats you the way they would want to be treated, and sometimes isn’t pushy enough. My approach earns me a living more slowly. But I have to live by my principles. Bear with me while I am still learning but let me earn your trust.

Integrity comes at a price. I have been living through what it is like to be hardly able to make ends meet. And I have learned about what “the system” offers. Still I trust in the value of waiting, in doing things right. In the end, I believe people will come to me. I will be recommended. I should be recommended. I will have to earn that. But that’s the right path. It is a path I’m dedicated to and grateful for, in fact, as I reflect on it this Thanksgiving Day, hoping for one last decent week in the Annual Enrollment Period as I finish my Z-pack. I say this not as a platitude but knowing with reborn clarity what drives me. You see …

Life in the nursing home. Who is there to love them? Who becomes family when family leaves them?
My sister was in a nursing home for ten years after her stroke before she died in 2016. Her husband married another woman and never saw her again. Who becomes family when family is gone?

When we moved to Tallahassee it was because my sister was in a nursing home on Medicaid here and she needed someone to check on her care. Spending every day visiting gave me a good dose of what life in nursing homes is like. Many were never visited by their families. Some didn’t have any. Many groaned in agony not to be tended to for a very long time. And we had moved my sister to Tallahassee because of the possibility she had been abused in her previous nursing home. In 2017, my brother also suffered a very humiliating death one year after my sister. Everything in me called for changing the way things were in that system. It wasn’t just about me and my realization that in the coming days I too would have to deal with stretching out a retirement income so that I wouldn’t have to suffer the death of the poor, or use up any savings paying for health costs, depriving my children of the privilege I had when I was young.

It all started to pain me when my son suffered with kidney stones at an even greater rate than I did. I regularly give birth to a stone at least once every seven years. I’m currently overdue for one. Maybe returning to the vegeterianism of my youth has helped. But as for the system, it lacked a sufficient health plan by the time my son suffered from his first one. And when I couldn’t afford the ritalin my other son needed to get through school, health plans were on my mind yet again – but by then I didn’t have a good group health plan from an employer, I was on my own and Obamacare hadn’t been invented yet. My wife had her stroke at thirty eight in 2003. She’s been paralyzed in one side ever since. This avalanche of health problems in my family happened shortly after this photo was taken, when I still had a good government job. Never mind the health expense; the loss of two incomes in the family, both hers and mine, resulted in bankruptcy and has made life difficult ever since.

The Carvin family – in the days before health problems shattered our dreams

This photo symbolizes a turning point for me. It represents the time before this endless struggle, crystalized by that bankruptcy, so hard to recover from as a sole bread winner and sole caregiver in a family with special needs. I’m grateful for this beautiful family and I’m grateful for me. I was a family man. What drove me was love. I’m grateful for that love. But I must admit that this was not a natural gift. My sister was abandoned by her husband when she had her stroke. I often thought of what life could have been like if I’d simply run from my difficulties, but such thoughts were always fleeting. I didn’t let them fester long enough to frustrate me and make me feel resentful. Never let temptation fester. It is inevitable. But its end is unthinkable.

I want to be honest with you. I’m not trying to paint myself as a saint. These are just my thoughts this Thanksgiving Day. Sure I put my best foot forward. That’s just professionalism. But honesty matters. I won’t go so far as to say I was grateful for my predicament or any of my hardships. I won’t even say that on Thanksgiving Day. Truthfully, sometimes I was grateful for my suffering but generally that wasn’t how my feelings would be characterized. But this isn’t about some display of humility. It’s actually something much better than that. In truth, any gratitude there occasionally was for all my hardships was as part of a larger package of love. Empathy is a love that doesn’t necessarily come from natural instinct so much as the pain of loss with its healing wounds and scars. Empathy was granted to me by my helpless sister. And to be even more accurate, it was first instilled in me by my mother, who saw me and saved and protected me often when I was beat up by my own older brother at a very young age. My sister’s room was also a place of refuge for me in those days. And my mother loved us all unconditionally. I learned forgiveness and unconditional love through her. My brother may have been rough, but we knew unconditional love. And for that, how could I be anything but grateful?

The beautiful women I used to run to for refuge on the left. Me with my wounds on the right.
There are two more older brothers missing in this photo. Getting beat up all the time had its benefits. Look how strong I was getting. Please note: The band aid on my head that day was not from a fight
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I have much to be grateful for.

Perhaps my mother’s protection set a foundation. My mother was strong and good. That in itself was an exceptional blessing. But it is said that in our weakness God’s strength is perfected. God spoke to me through my helpless sister, reminding me of the helplessness I once felt as a toddler seeking my mother’s protection. You see, any grace I have in having acquired exceptional love, comes from a divine purpose, where all such things came together for good in me. Only through my sister’s suffering could I have fully felt this. I simply couldn’t imagine a world where my wife was abandoned the way my sister had been. I don’t attribute my compassion for others to any natural gift of mine. I absorbed it the hard way. I felt my sister’s pain. And it seems, after all is said and done, that these health issues have to some extent shaped and defined my calling. That’s something I’m grateful for in this moment. There is purpose underneath this hardship. I wish I always had an attitude of gratitude. I do at times. But most importantly, I have love. Not necessarily being loved by others, but being inclined to love others, even those who hurt me.

Salesmen are succinct. I blog. Alpha males never show vulnerability. They just win. That’s how people are designed. And most aren’t alphas. I’m not one. I’m not a beta either. I’m confident in who I am. I’m happy to hold a meaningful conversation. And few would fail to describe me as a leader. Look up sigma males and that’s where I think you’re likely to find me. Vulnerability may turn women off, but I’m not on a woman hunt and as vain as I sometimes can be, I’m becoming too old to care. Commanding conversations may be useful for phone skills in sales, and I may not be as good at curt persuasion as I wish I was. But like the sign on my sister’s wall said, “God doesn’t make no junk.” She lived by that and so can I.

So as I’ve reflected on my life in this recent quiet time, what I’ve sensed God saying is that I’ll be okay just the way I am. I just need to slow down and not beat myself up for failing to meet my own unreasonable hopes and expectations. I’ll be able to provide for my family, and perhaps, as a bonus, He will in the years to come, still speak through me not just through the wider vision I’ve shared through through the years as I’ve set the foundation for The Pamalogy Society and all it might potentially entail, but at least, and perhaps foremost, by utilizing these life lessons to build my legacy one step at a time, even with a modest if lengthier than hoped daily struggle paying monthly bills at the present time as I build my insurance business. Whatever is being molded and shaped in me, that is what I’m grateful for. I release my own vision and invite whatever is most pleasing to the Lord by His greater strength, knowledge and wisdom, and offer my utmost gratitude to God’s grand design, rather than my own, as wonderful as what I already see may seem. My own best masterpiece will be the path of least resistance to that of my Designer. In this work, not just in my own life, but in the fullness of that Realm, I not only bring my utmost gratitude, but rejoicing and awe. And my best advice to you on that is … Be there!

Mo

Location, timing, location

  • Annual enrollment period for Medicare is October 15th through December 7th.
  • Open enrollment season for the Federally Facilitated Marketplace is November 1st through January 15th.
  • Many group health and private health insurance plans limit enrollment and changes to similar time frames.
  • Medicare offers an open enrollment period for those who want to make changes to their Medicare Advantage plans from January 1st through March 31st.
  • Initial enrollment periods for Medicare begin three months prior to the month of your 65th birthday and end the end of the third month after the month of your birthday.
  • Special enrollment periods take place when events trigger them.
  • Qualifying for social security may happen at a young age if a person is disabled. Being eligible for social security benefits can make a person eligible for Medicare before the age of 65.

You’ll find me out at local pharmacies here in Tallahassee during enrollment season. More info on that to come. Stand by.

Front Page

I’ve been working on my branding problem in my spare time. It’s been a daunting project. What’s on your front page? If you were to tell your story, where would you begin? Would you start at the end, the beginning or somewhere in the middle? What theme would you highlight? What would you want the world to know?

Business Card version 12.7

It’s easier for some than others. My latest card involved a simple change of phone number from the previous one. I’ve also changed my email address. But those aren’t branding issues. It’s the images and logos. There is a story behind each one of them. Most people would opt for simplicity. Why did I put a hat on that dolphin? Why two that aren’t the same? What are these other symbols?

Simplicity

The cardinal rule in marketing and advertising is “less is more.” I’m going to advertiser hell for this business card. I know it. But it gets worse. Here’s the back…

The back of Business Card version 12.7

Yeah, that’s right. So unprofessional. Why?

Marketing Organizations vs Products

As an independent insurance broker, I can contract and produce insurance products for all sorts of companies. I’m in charge of choosing what I can recommend and I really like that. I contract with more than most independent brokers because I’m about people more than I’m about commissions. People have a variety of needs and qualifications. But I have a problem. I do want to bring attention to the companies I work with and to the insurance products I offer, but I need a single message – a simple idea. So what single message do I want to bring recognition to? Here’s my challenge …

I’ll start with marketing organizations. A field insurance marketing organization provides a nice plug and play system. The hard work of contracting is made easy.

I started my insurance career with one of the largest life insurance marketing organizations in the country – Family First Life.

FFL works with dozens of life insurance carriers, offering hundreds of life insurance products. Some of the names are already well recognized – names like Mutual of Omaha, Gerber, John Hancock, Aflac and Corebridge. Others are lesser known but quite good.

Then came Benzy. I had wanted to offer health insurance from the start. As an Independent Marketing Organization, Benzy offers two types of products – (1)Health Matching Accounts (HMAs) and (2)private health insurance plans. The insurance plans are with Allstate and Manhattan Life.

Let me offer a quick overview of the types of health insurance products this world has and where Benzy fits in. Health insurance products fall into a number of buckets. There are those that focus on the senior citizens and the Medicare/Medicaid market. And there are those who don’t. With the exception of the HMA, Benzy is for those who don’t. This latter bucket is then itself divided into two general categories – those who need comprehensive insurance to cover preconditions, and those who don’t. Again, with the exception fo the HMA, Benzy’s current line up of products through Allstate and Manhattan Life is for those who don’t. Then finally, there are those who can afford ACA plans (Obamacare) and those who can’t or are unwilling. Benzy products are for those who’d like to pay less money than they would with the Federally Facilitated Marketplace (FFM), which is how the Affordable Care Act (ACA – AKA Obamacare), attempts to make health insurance affordable for everyone. Benzy products don’t offer Obamacare. They offer more affordable alternatives. If government cost sharing and tax credits are needed, I provide that through Kellogg.

My goal was to offer every bucket. What Benzy didn’t do as a marketing organization, Kellog did do. If someone needs Obamacare, I can offer a variety of ACA Federally Facilitated Marketplace products. And if a person has, or needs to get onto Medicare, I have numerous carriers and products for that thanks to Kellogg. There are all sorts of things these organizations do for me in terms of back office support, lead generation, training and marketing so I don’t have to reinvent the wheel.

All that said, I can contract directly with carriers, as well. Tallahassee is one example. It’s my goal to represent all the best plans here in my local market. It’s a changing target that required a lot of training and certification so it’s no easy task, but to provide solutions no matter what the needs of my client are, it’s all part of what I do. I don’t want to be a salesman. I want to be a consultant. My job, is to simplify the complex by knowing how to explore options quickly and distill information into what matters most to my clients.

On this current iteration of my business card, I’ve chosen to add the logos of these three major marketing organizations. Without them, I would never have been able to start my business. Later, I’d like to train and organize an agency of my own. If you are interested in the insurance business, or know someone looking for a great career, I’m happy to mentor new agents. In a later, more simplified version, I’ll remove the IMO logos from my front page and business card. You only want one image. Right? Well … that leaves me with my dolphins. Ultimately, what I’m marketing is James Carvin Insurance. I want you to see my brand, not theirs. But to know my brand is to know my story. Would you like to know about me?

My Story

I’ve got a lot of content on the web. I started telling stories about my family after my father passed in 1995. I was working on my Masters degree and serving as an adjunct professor at a seminary at that time. There were group chats and forums avaialable on Compuserve back then. I was heavily engaged. Then later, I put up a lot of theological content on a group called CARM, as well. I also had a MySpace page and about a dozen others, all before Facebook existed. I owned and put up content on about forty domains to theme out my various interests. On Facebook, I manage dozens of groups and pages.

Despite all that, I never made the connections I wanted. One web site I built had over a hundred million page views in a three-month span but, as with several other businesses I hoped to get up and running, I was never able to raise funds. Ultimately, I had to set the whole enterprise to the side for another day and reinvent myself.

Business Card
Business Card Version 12.5

Recent Reinvention

I got another degree. This one was in Interdisciplinary Studies at ASU. I busted through it easily in my part time with a 4.0 while I drove for Uber and Lyft. Uber paid for my degree. I thought better credentials might be useful and it only took a few years, so why not? IDS degrees are for those who want double majors. My concentrations were in philosophy and organizational leadership. My goal was to start a philosophical society. I call it the Pamalogy Society. Pamalogy is the philosophy of awesomeness – Awesomeology. It was a great idea, but back to the same old problem – I’m not a fund raiser at heart. I’m an inventor. So I haven’t yet gotten my philosophical society off the ground.

Meantime, I have bills to pay. What I needed was a business I didn’t invent from scratch. The insurance business solved that problem for me. Multi-billion dollar insurance companies needed knowledgeable people to offer their knowledge and expertise. I could do that. Why not just be an awesome insurance consultant? I can make a difference in people’s lives. That matters. And there were very few start up costs. But about that branding …

Can Dolphins Wear Top Hats?

I got baptized with my top hat on.

Really.

A logo that got baptized?

The top hat with sprocket is the Pamalogy Society logo. Top hats symbolize excellence. Sprockets symbolize innovation. Surely we are endowed with great imaginations and can invent new forms of excellence. Isn’t that what awesomeness is? When I put on my top hat, I recognize my call to excellence and innovation. Don’t think in problems. Think in solutions. Let me find you your solution! Are you paying too much for health care? Have you built a financial and digital legacy for your family? Did you fall in love with a charity you wanted to help?

What’s Baptism?

I should be clear about this top hat deal. What’s the top hat about? Innovation? Excellence? Baptism?

Top hats tend to be symbols of success. But a Pamalogy Society top hat is not a declaration of success. It is a declaration of calling. It is a challenge. It is a reminder.

Top hat with steam punk theme
Declaring innovation means declaring change

That’s why I got baptized wearing my top hat. Baptism is not a declaration of success. It is a declaration of a new identity. Baptism goes beyond reinvention and human creativity. It applies hope and faith to something that it envisions and calls upon. Baptism knows what it sees in part but it doesn’t pretend to grasp it entirely just yet. Its calling may be unknowable, in fact, yet faith and hope may be part of a baptism sufficiently to know and trust that whatever is to come is good and that we are entering into it.

That’s how baptism works. Its power and declaration are incomprehensible in this world. Eye has not seen nor has ear heard it.

Why Dolphins?

Did that sound deep? As a philosopher, I ask big questions. One of them is what maximized awesomeness is. A theist will say God is maximized awesomeness. I agree. Maximized Awesomeness is exactly what God is. Perfection. You can’t get any better than that.

But when discussing philosophy, I aim for precision. I can’t be precise if the term “God” doesn’t mean the same thing for every person. It doesn’t.

I decided not to change my LinkedIn profile when I went into the insurance business.

Neither does the phrase, “maximized awesomeness” mean the same thing to everyone. Thank God for that. Now if I talk about mazimized awesomeness, for the sake of precision, I can consider each possible domain. How I can mazimize my awsomeness is one thing. How the world could maximize its awesomeness is another. Then there is what the best truth conceivable is – that is yet another thing. When we think about God, many of us think of that thing.

Maximized Awesomeness in that sense is that than which there could be nothing greater – a very specific description of God. That would be Perfection. But not everyone sees God as perfect. I wind up in discussions about why there is evil in creation. But that’s not what I’m going to talk about here. Here, I’m going to talk about dolphins.

A very smart looking dolphin. Don’t let convention fool you. Sometimes the smile is in the eyes.

Dolphins fall into the “this world” category of awesomeness.

Why do I like dolphins so much? Well … they are usually very friendly with us. They aren’t always friendly though. Some of them injure other animals. In fact, all of them do because they eat fish. Fish are animals. Manatees are much nicer.

Some people say animals don’t go to heaven. I don’t think that is true. I think the fundamental difference between humans and other animals is that we are more capable of intentionally knowing good from evil and seeking to change our behavior in order to seek the good and repent. We reject our own habits deliberately, purely for the sake of good.

I wouldn’t say animals can’t or never do consciously change their moral behavior. I’ve seen animals mourn. I’ve seen them groan with compassion. I’ve heard stories about them rescuing people. I’ve seen shame on dog’s faces. Who trained them to do that? Animals of many species often surprise us with kind and selfless acts. So why dolphins? It’s not their built in smile. That’s delightful but my dog gives me unconditional love too. Even my hamsters and guinea pigs loved me.

A dolphin with seven stars wearing a Pamalogist's top hat.
The Pamalogist’s top hat is distinguished by sprockets. The seven starred dolphin is another story.

You know what it is? It’s their blow hole. Like a person being baptized, they go under the water and come back up so they can keep on living. Whales and other sea mammals do the same, I know, but dolphins, being roughly the same size as humans, and having a brain size to body mass ratio that is even bigger than humans, symbolize baptism for me. We definitely have to wash that intelligent brain free of stinking thinking and dolphin brains are bigger than human brains. Seals are sea dogs – so cute and pretty smart too. But they don’t have special blow holes declaring to the world their need to breathe and be born again. Seals, otters and penguins, manatees – I know. They’re all cute. They’re all amazing. But dolphins …

Dolphins are my personal brand. I won’t ramble. Do you want to know about the seven stars? Maybe another time. Suffice it to say there is a reason the dolphin with seven stars is the brand I chose. Putting a top hat on it was a very personal thing for me. The seven stars may stay but the hat is not going to be part of my long term insurance company brand. It belongs to my philosophical society brand. If you are interested in my philosophical concepts, let’s talk about them. As for my insurance brand – I will simplify. Give it some time.

What’s on your front page?

The Multiverse

I’ve become an insurance agent. If I had my way, things would be very different. There would be no need for insurance – neither health insurance, nor life insurance. There would be some forms of property insurance, but that wouldn’t involve money. It would involve privilege and rights. It’s a long story. But I don’t mind sharing it. Do you have a moment?

Well, if you are interested in insurance as privilege, click here. That’ll take care of that. But to get to what drives me, I’ve got to start at the beginning. The drift of it all begins with the question of what is wrong with everything.

I’m serious. What is wrong with everything?

We don’t know the small, the large, the young or the old. Could pure reason explain it better?

You might think I’m asking a rhetorical question, but I am serious. And on a metaphysical level, I’m being literal – what is wrong with everything? And …

… what is everything to begin with? The particle physicists can’t even tell you what quarks are made of. The cosmologists don’t know how big or old the Universe is. How can we delve into what is wrong with everything if we don’t know what everything is?

We might also ask why everything is. Why?

As a philosopher, I think the answer to this second question provides the key to the first. The purpose of everything is the maximization of awesomeness. This is not just a catchy phrase. It is the actual reason. If you want to follow my reasoning and see how I came up with this answer, subscribe to Season One of my Podcast. I’m 100% serious.

So that takes care of that.

If you follow those links, you’ll see that I’ve covered a lot of ground I won’t have to repeat here. Let’s start with that context. Assume for a minute I’m right. If so, then the why question leads us to other big questions. Is what concerns us on a daily basis fufilling our purpose? If we are here to maximize awesomeness, then how? If your life is just, “blah” and “getting by” then does it concern you at all that you may have been missing out on something wonderful? Why is your answer not the maximization of your awesomeness?!

What if everything was very different? Imagine, for instance, if we had always lived in an incentivized asynalogonomy, rather than in the constant tension between capitalist and socialist dystopias. (Click here if you don’t know what that means).

There are better ways to deal with economic problems than plagues and wars. Just sayin’

If only more people knew about the HAND System. (Refer to the above link if you don’t know what the HAND System is). I believe that in the Multiverse, there are many Universes that incorporate the HAND System. I believe there are a vast number of worlds that aren’t nearly this dysfuntional. I’m presently in the insurance business because this world doesn’t know anything about the HAND System. They don’t know that it would fix this world much better than insurance ever could. People don’t know. So I have to settle for the insurance business.

I know that all sounds strange. I’m a little geeky, I know, but I’m not so other-worldly. In fact, I’m perfectly normal and safe to be around – just a little different than what you’re used to. And I can be practical. I may not be of this world, but I live as though I’m really in it. My philosophy holds that this world is at least partially real, even if it seems to be falling apart. Belief in the Multiverse as a product of Maximized Awesomeness does not make a person so other-worldly that they can be no earthly good. I see it as my mission to make this world a little less bad for people, if I can.

Other worldly leadership?

The Ghost Machine was another example of an attempt I made to maximize the good, as I knew how, given what I knew and thought I might be able. As with all of my business ventures, I started with the belief that it wouldn’t necessarily take money to make money. I still haven’t given up on that thought but I’m reminded daily of how pollyannic the concept is. I so much wanted that to be true. I had very little money. If I wanted to be in business for myslef, it would have to be true.

My father hadn’t wanted me to go into business for myself. He knew I wanted to have a positive impact in this world, one that required some entrepreneurial courage, but he wanted me to keep the good government job I had. He said that all the people he knew who’d gone into business for themselves had sacrificed a life without worry. Taking risks could rob a person of their time and of their health. He tried to spare me. He meant well. And I know he was right.

Dad spoke from his personal pain. He had lived in a very different world. It started well enough. He had inherited a fortune from his own father. He started out with a great career in textiles his Dad, my Pop Pop, Charles Carvin, Sr. had taught him. Dad became a marketing man in the textile industry. Even before his Allied Chemical days, he was doing commercials for Chemstrand. If you followed the Netflix series Madmen, you may have caught some of the flavor of my father. He had a trophy wife in Rye. He took the same train from Mamaroneck to Grand Central Station and back every day. “Draper” was even the name of one of his peer VPs at Allied.

One of Dad’s Chemstrand Commercials – images of home

I hope you enjoyed that video. Please watch it. See what I mean by “flavor”? And if you are really astute, you may have found the word, “Cumuloft” familiar too. Well, I should tell you that I was no more than one or two years old when the above commercial was made. Dad’s move to Allied’s Caprolan from Chemstrand was in 1962 and there was no more talk of any Cumuloft after that, if there ever was any in my presence. Assuming it wasn’t just a coincidence, somehow the term “Cumuloft” appears to have managed to stick in my young brain for forty years or so before I incorporated it into the Ghost Machine. The Cumuloft was the Ghost Machine’s “cloud” security storage system. Then one day, I decided to check to see if “Cumuloft” was a word I could trademark. The Internet didn’t show me anything at the turn of the Millennium, as I was developing the Ghost Machine’s blue prints. I only encountered my own father’s commercial, well after that search. I wonder what else is stored in my head without my knowledge. I don’t think we found this video until about 2016. Development of the mobile app started in 2011.

But I digress. Thinking about Dad can make my mind wander. I was talking to you about the insurance business. Specifically, I was thinking about how a person like me, who’s head is happier in the clouds, could possibly take interest in solving the problems inherant in dystopian economic systems. Insurance is a help. I was telling you it was the best I could do. At least it helps some people in this world. I’m sure there are many Universes much like this one where it comes in handy.

And I was telling you about the Ghost Machine. Like the insurance business, it would have put a bandaid on socio-capitalism. The idea was to create a fun way for people to make money. This world can be a very dull and even cruel place. Why isn’t earning a living easy and fun? It’s such a shame I was unable to raise the cash needed to build the Ghost Machine. The world would be a very different place right now if I had succeeded.

Use the ghost machine's finder to plan your ghost hunting all day long every day so you can earn Ghost Bucks!
The Ghost Machine App
Pokemon Go meets Bitcoin

with some ghostly edutainment

At least in the insurance business I don’t have to start from scratch. There’s already billions and even trillions of dollars in this business. Getting my personal brokerage started has taken time, more than money. I was able to survive on rideshare earnings while getting my first few sales. It didn’t take hundreds of thousands of dollars.

But you deserve a little more back story.

Dad lost his fortune. My mom, who outlived him by decades, lived a miserly life after he passed. And she was spared the difficult ending to her life that my sister and brother had. She was in great health clear up to the age of ninety. Then she had a heart attack. She never had to pay for assisted living, much less a nursing facility.

Contrast that with my sister, Corinne. She had a stroke ten years before she died. The majority of her remaining years were spent on a feeding tube in a nursing home. Her husband abandoned her. Her four remaining brothers deliberated over her care. One wanted to put her on palitative care and another thought she wouldn’t want that and the right thing to do was to bring her to a new nursing home in Tallahassee. He prevailed. And that is why we moved here – to watch over her before she died.

My wife, six years my younger, also had had a stroke the year before my sister, six years my elder. She was only thirty eight. She’d been in perfect health until it happened in 2004 but she’s been paralyzed in her left side ever since. It shows me that bad things can happen to anyone at any time. Jeanne Calment, who according to the Guiness Book of World Records is the oldest documented woman to ever live, was a smoker. Lisa never smoked, drank or took drugs and she worked out regularly. Bad things happen to good people. It doesn’t matter how rare it is. It happens. And that is why we have insurance.

We still managed to have some good times after Lisa's stroke even when we had no money. Hardship is bad. God is better.
We still had some good times after Lisa’s stroke even when we had no money. Hardship is bad. But you can work through it.

With that picture, it may make better sense why an inventive philosopher would wind up in the insurance business. It positions me to help people deal with the hard realities that exist when bad health, or death, comes at an unexpected time. We can deal with problems before they happen. I can’t prevent an occult arterio-veinous malformation, like Lisa’s, from bursting. But I can make it easier for families to deal with the financial issues that ensue if and when such a thing happens.

And it wasn’t just Lisa, or my sister Corinne. Do you know what was really eye-opening to me? It was visiting Corinne in that nursing home. Nursing homes are places filled with people suffering. I wish more people knew. Maybe they would visit them. There is so much loneliness there.

And they need care. They shouldn’t go without much needed care. Caregiving takes money.

I don’t mean family caregivers. Lord knows I’ve never been paid for family caregiving and few have. Maybe we all should have been and maybe there are even some insurance plans, ones that I can even write for, that actually cover that to some extent. If anyone would know about those plans, I would. But what I mainly mean is professional nurses, doctors, medications and treatments. It all has to be paid for.

So, I’ve decided that the best way for me to maximize my personal awesomeness, is to learn all I can about health insurance for young and old. And life insurance too. When I was young, I had my days of fun and adventure. I have no shortage of stories to tell. But I continue to ask how I can do the most good for the most people – not just myself – before I die. I continue to focus the answer on the areas I would be most capable of. I still have a few brain cells left. Let me see what I can dig up for you. You have not because you ask not.