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Tuesday, August 31, 2010

Claim Example: Inguinal Hernia Repair in a Dachshund

As the final post of our focus on obesity this month, I thought it a good example to use where this hernia could have possibly been prevented through weight management (although such a young dog is likely to have needed surgery no matter what).

An inguinal hernia is a defect in the opening from the abdomen down to the testicular sac and obesity sometimes can change something miniscule and not noticeable into a serious condition that needs surgery to fix the defect.

Details of the claim for Roxy, a 1 year old Dachshund living in Pomona CA:

DATE	ITEM	Tax	BILLED AMOUNT	COVERAGE TYPE	COVERED IN POLICY?	COVERED CHARGES
11/7/2009	Examination		$ 42.00	IL	Y	$ 42.00
11/7/2009	Radiograph Abdomen		$ 159.44	IL	Y	$ 159.44
11/7/2009	Chem 5 (5-6 Tests)		$ 60.70	IL	Y	$ 60.70
11/7/2009	Total Body Function		$ 143.00	IL	Y	$ 143.00
11/7/2009	Ova/Par-G 1 yr		$ 53.00	IL	Y	$ 53.00
11/7/2009	Fluid Therapy Set Up		$ 92.40	IL	Y	$ 92.40
11/7/2009	Fluid 1st Bag		$ 0.00	IL	Y	$ 0.00
11/7/2009	IV Catheter		$ 0.00	IL	Y	$ 0.00
11/7/2009	IV Administration Set		$ 0.00	IL	Y	$ 0.00
11/7/2009	Fluid Pump		$ 18.95	IL	Y	$ 18.95
11/7/2009	Hospitalization		$ 77.00	IL	Y	$ 77.00
11/7/2009	Occupancy		$ 0.00	IL	Y	$ 0.00
11/7/2009	Nursing Care		$ 0.00	IL	Y	$ 0.00
11/7/2009	Prof Care		$ 0.00	IL	Y	$ 0.00
11/7/2009	Intensive Care Level 1		$ 15.45	IL	Y	$ 15.45
11/7/2009	Exam Pre-Anesthesia		$ 0.00	IL	Y	$ 0.00
11/7/2009	Preanesthes/Induction		$ 57.85	IL	Y	$ 57.85
11/7/2009	Gen Anes 1st 1/2 hr		$ 118.60	IL	Y	$ 118.60
11/7/2009	Gen Anes Add. 15 min		$ 53.30	IL	Y	$ 53.30
11/7/2009	Anes Monitoring Lv 2		$ 63.20	IL	Y	$ 63.20
11/7/2009	Hernia -Inguinal		$ 494.35	IL	Y	$ 494.35
11/7/2009	Nursing/Injections		$ 59.00	IL	Y	$ 59.00
11/7/2009	Ampicillin		$ 19.48	IL	Y	$ 19.48
11/7/2009	Injectable Buprenorphin		$ 27.07	IL	Y	$ 27.07
11/7/2009	Amoxicillin		$ 20.80	IL	Y	$ 20.80
11/7/2009	Metronidazole		$ 50.70	IL	Y	$ 50.70
11/7/2009	Tramadol HCL Compounded		$ 34.30	IL	Y	$ 34.30
11/7/2009	Intest HE K9 14oz Can Qty 10	Y	$ 25.80	MI	N	$ 0.00
11/8/2009	Day Hospitalization		$ 46.20	IL	Y	$ 46.20
11/8/2009	Intensive Care Level 1		$ 15.45	IL	Y	$ 15.45
11/8/2009	Fluid Therapy Nursing		$ 15.45	IL	Y	$ 15.45
11/8/2009	Oral/Topical Nursing		$ 9.60	IL	Y	$ 9.60
11/8/2009	ChlorhexiDerm Flush		$ 19.20	IL	Y	$ 19.20
11/8/2009	Gentamicin/Clo		$ 26.18	IL	Y	$ 26.18
11/8/2009	Medical Waste Fee		$ 4.99	IL	Y	$ 4.99
11/10/2009	Metacam		$ 32.48	DD	N	$ 0.00
11/7/2009	Tax		$ 2.26			$ -
Total			$ 1,858.20			$ 1,797.66

Roxy's policy had a $200 annual deductible, a 20% copay % and a $10,000 annual maximum but no drugs and dental coverage selected for a monthly premium of $32.50. The payout on the claim was calculated as follows (taken directly from the claim Explanation of Benefit)

STEP 1: Calculate Potential Refund
Billed Amount:		$ 1,858.20
Covered Charges:		$ 1,797.66
Annual deductible remaining		$ 200.00
	subtotal	$ 1,597.66
Copay 20%	(your copayment)	$ 319.53
Potential Refund		$ 1,278.13


STEP 2: Compare potential refund against your annual maximums
Annual Maximum		$ 10,000.00
Prior refunds for this policy year		$ 0.00
Coverage remaining		$ 10,000.00

Your total refund is:		$ 1,278.13

Is this something you've come across in your dog?

Related Posts:
August is Obesity Month at Embrace Pet Insurance
Claim example: orthoscopic surgery to fix cranial cruciate ligament rupture in Rottweiler
Guest post: number one pet health problem is obesity
Measuring my cats' body mass index - the FBMI
Claim Example: Inguinal Hernia Repair in a Dachshund

Posted by Laura on Tuesday, August 31, 2010 at 07:55 AM | Permalink | Comments (0)

Monday, August 30, 2010

Measuring my cats' body mass index - the FBMI

A couple of weeks ago, I came across an article by Dr J (though twitter) on the Feline Body Mass Index. It's the same concept as the human BMI measurement where you look at a person's weight and height and work out the percentage of body mass made up of fat.

Being the math geek in me, the article had a formula for calculating a cat's body mass index so I thought I'd give it a whirl for my two 1 year old indoor cats, Rocket and Rosie (who will forever be known as The Kittens in our household).

Here's your cat’s FBMI calculation:

While your cat is in a standing position, with the legs perpendicular to the ground and the head upright (good luck with that!):

Measure the circumference of your cat’s rib cage. (The level of the 9th rib is ideal.)
Now measure the length of the lower back leg from the knee to the ankle and write down both numbers, because with what is coming, you probably won’t remember them.

Calculating the FBMI

Divide the rib cage measurement by 0.7062 and subtract the length of the leg.
Divide that answer by 0.9156.
Subtract the leg length from that number, and that is your cat’s BMI.

And here it is in action for Rocket and Rosie (it was not easy to get them to stand still for the measurements - tape measures look like fun dangly things to feisty young cats):

BMI calculation	Rosie	Rocket	Plump
(1) Rib cage	15.0	15.5	32.6
(2) Leg	4.0	4.0	4.0
(3) = (1) / 0.7062 -(2)	17.2	17.9	42.1
(4) = BMI = (3) / 0.9156 - (2)	14.8	15.6	42.0

Since a cat is considered overweight, or plump, at a FBMI score of 42 or more, I also worked out what waist my cats would have to have to be considered overweight - the "plump" column in the table above.

Instead of 15-16 inches it is now, they'd have to double their girth to be considered overweight. Quite frankly, I'd be worrying well before that and putting them on a diet much sooner. I might consider the double girth as obese, not just overweight, but that's just me.

So instead of relying on a formula to know if your cat is overweight, follow the following rule of thumb:

If you can't feel your cat's ribs when you run your hand down her chest, she likely needs to lose a pound or two.

Some other tips from Dr J on managing your cat's weight:

feed high quality food (we feed the kittens Wellness canned twice a day and some Core dried kibble to go with it)
limit free feedings (we do free feed some Core during the day but only enough for both cats to be done during the day before night time feeding)
exercise freely (both are indoor cats but we have play time in the evening and they love racing up and down their cat tree and chasing puff balls around the house)

It's hard keeping an indoor cat trim but definitely worth the effort I think. How do you manage with your cats?

Posted by Laura on Monday, August 30, 2010 at 08:04 AM | Permalink | Comments (5)

Friday, August 20, 2010

Other interesting changes in the Embrace Pet Insurance policies

You'd think that after the last 6 posts on the pawsome changes to our policies in our move to RLI (see Embrace has a new insurance partner - A+ rated RLI Corp), I'd have exhausted the list by now but there's still more:

you can now get a policy for a 6 week old pet and up (used to be 8 weeks)
we have new deductibles, including a $1,000 a year deductible. The premiums on these sweet policies are really really low
and did I mention we cover prescription diet cat and dog food in our Wellness Rewards Plus plan, as well as gastropexy, OFA and PennHIP x-rays, and umbilical cord repair? I probably did but I really like those new additions! :D

OK, back to work now. Just thought you'd like these nice extras to wrap up the week.

Posted by Laura on Friday, August 20, 2010 at 08:09 AM | Permalink | Comments (7)

Thursday, August 19, 2010

Embrace Continuing Care Sublimits have gone!

Note that this post has been updated for Dec 31st 2010 conversion date.

No more sublimit on the Embrace continuing care benefit (see Embrace has a new insurance partner - A+ rated RLI Corp).

Yesterday, I talked about cleaning up some niggling things about the Embrace Pet Insurance product, specifically the Embrace dental illness coverage.

Today, we talk about the old Embrace continuing care sublimit of 25% of the annual limit in the second year of the condition.

I've never liked the sublimit but it was something that Lloyd's felt strongly about so that is what we offered. Now that we have some claims experience under our belts, RLI agreed with us that we could remove the sublimit if we added a lifetime limit of $50,000, so we agreed - woohoo! I'm thinking that a $50,000 lifetime payout limit is more than enough for any one dog or cat, don't you think?

Another thing to note is the lifetime limit only applies to RLI claims so if you had claims with Lloyd's before you moved to RLI, they don't count towards the limit. Another woohoo!

So, what does mean for those of you with Lloyd's policies? To set the stage, there was a period of about 4 months where we converted various states from Lloyd's of London terms and conditions to RLI terms (see Lloyd's, RLI admitted and RLI Mt. Hawley states here).

Now we are the end of the year, most of the states are with RLI (all states except MA, NY, FL, and WA), with those 4 exception states being issued on Mt. Hawley paper (a subsidiary of RLI) using the Lloyd's terms and conditions. The one change to the Lloyd's terms for Mt Hawley is that the continuing care sublimit has gone and the lifetime limit is in.

In summary in regards to the Continuing Care sublimit:

If you bought a Lloyd's policy recently, you will renew into an RLI policy. The good news for you is that the continuing care sublimit will have no impact on you since it only comes into effect in the second year (and you'll be cozy with RLI by then)
If your renewal is coming up, you will have no continuing care sublimit and you move to the lifetime limit that only counts claims with RLI

The interesting thing about the continuing care sublimit is that is had very little claims impact in the grand scheme of things but people felt it very restrictive (can't blame them - I agree!) so I'm glad we got rid of it.

Any questions?

Posted by Laura on Thursday, August 19, 2010 at 07:45 AM in Embrace Pet Insurance, Embrace products, pet insurance , pet insurance news, RLI Corp | Permalink | Comments (2)

Wednesday, August 18, 2010

Anyone interested in some Embrace Dental Rewards? Pick me, pick me!

Introducing the new Embrace Dental Rewards Plan, which covers the prevention and treatment of cat and dog dental disease!

Since Embrace launched in 2006, a few small things have been niggling me about our Embrace Pet Insurance policies, one being the way we covered dental illnesses:

Dental accidents are covered in the base Embrace health insurance product, just like in the human world, but our dental illness treatment coverage was lumped in with our prescription drug coverage - many people wanted to buy them separately
our dental illness treatment did not cover teeth cleaning, which disappointed pet parents :(
and dental illness is generally preventable so it felt odd to have coverage for the illness without the prevention (the teeth cleaning)

So, when we worked on moving our policies over to our new insurance partner, RLI (see Embrace has a new insurance partner - A+ rated RLI Corp), we decided to do the whole thing over and the Embrace Dental Rewards Plan came about.

Here's what it covers:

Dental Rewards is just like the Wellness Rewards Program in that it is not insurance but something more akin to a health spending account for the prevention and treatment of pet dental illnesses.

There are no sublimits on each procedure - you get to chose how you spend your money.
There are no deductibles, no copays, and no waiting periods so you can use it right away.
If you pay upfront for the year, you pay $101 less than the $400 benefit you can use so if you know you are going to have your dog or cat's teeth cleaned, you would make money on it. For monthly policies, the gain is about $53. (that's why it's called a Reward :) )

Note that:

Dental accidents are still covered in your regular Embrace Pet Insurance accident and illness policy
if you had the Drugs & Dental extension on your Lloyd's policy, you'll still have the Prescription Drugs plan on your RLI plan

We like preventing dental illness in our dogs and cats - don't you?

Posted by Laura on Wednesday, August 18, 2010 at 07:24 AM | Permalink | Comments (0)

Tuesday, August 17, 2010

The new and improved Embrace Wellness Rewards program

Since introducing the Embrace Wellness Rewards program in 2009, we've been loving the attention our Embraced pet parents have been giving it. Many people love the program and have given us lots of feedback on how to improve it, particularly increasing the limit and giving us a laundry list of items to add to it.

So, as part of our recent insurance product changes, we took the opportunity to make a few changes to the Wellness program as follows:

we have added nail trimming, anal gland expression, gastropexy, and umbilical hernia repair to the Wellness Rewards plan
we moved the dental cleanings out of the Wellness Rewards coverage into the new Dental Rewards coverage so the dental illness prevention and coverage were in one place (just like human dental coverage) - more details in a post coming later this week
in addition to the $200 Wellness Rewards coverage level, we now have Wellness Rewards Plus with a $400 limit. This will help those pet parents who live in an area with high veterinary costs (like NY and LA) or those with a lot of routine visits to the vet
- Rewards Plus covers the same as the basic Wellness Rewards coverage but with a higher limit and also adds prescription diet food and OFA and PennHIP examinations.
for costs, see the flyer below

I think most people are going to find something here to please their budget.

Posted by Laura on Tuesday, August 17, 2010 at 06:24 AM in Embrace Pet Community, pet products & services | Permalink | Comments (2)

Monday, August 16, 2010

PennHIP Pet Insurance Discount now available at Embrace Pet Insurance

Embrace has always been proud to be one of the very few companies that covers hip dysplasia, but now, as part of our move to RLI as our new insurance underwriter, we’re excited to offer a 5% discount as an additional incentive for pet parents that utilize the PennHIP (University of Pennsylvania Hip Improvement Program) test.

PennHIP testing is offered in hopes to help reduce the frequency of hip dysplasia. Once a pet parent has a series of hip x-rays completed, the films are screened and graded by a certified vet and entered into a veterinary database to help analyze dysplasia severity and frequency.

PennHIP testing is valuable for breeders that want to ensure that their puppies are not likely to develop hip dysplasia, and should be considered necessary for anyone looking for a healthy puppy, if that breed is likely to develop hip dysplasia.

In order to qualify for the Embrace PennHIP discount, your pet must have received a score of 0.3 or less. If your pet qualifies, fax (800-238-1042) or e-mail (claims@embracepetinsurance.com) his/her test scores to us and we’ll take care of the rest.

[Note that this discount applies to RLI policies only, so if you currently have a Lloyd's policy with Embrace, send in the information in advance for when your policy renews to an RLI policy.]

Posted by Laura on Monday, August 16, 2010 at 05:02 AM in Embrace Pet Insurance, pet insurance , pet insurance news, RLI Corp | Permalink | Comments (0)

What the new Embrace / RLI partnership means for you - new terms and conditions

As you may know, we have a new partnership with RLI Corp who is underwriting the Embrace Pet Insurance policies in certain states at present (for an up-to-date list, see the Embrace Pet Insurance website.)

As part of that transition, we have updated the Embrace Pet Insurance terms and conditions. I have summarized the RLI differences below - I think you will find these to your liking.

Improvement:
The RLI terms and conditions document is only 8 pages long so it is much more readable than our previous that was 20+ pages long!
Clarification of our current practice:
We removed the term UCR (usual, customary and reasonably payments) regarding our claim payments and clarified that we pay based on the actual vet bill the pet parent paid - since this is what we actually do. No point confusing things unnecessarily.
Clarification of our current practice:
The claims appeals process has been added – pretty much what we do now with the addition of a second appeal determined by an impartial veterinarian.
Relaxation of terms:
We removed the arbitration clause - RLI's legal group prefer it that way
Relaxation of terms:
The claims submission period has been increased to 90 days, up from 60 days it used to be
Moving some coverage pieces around:
We used to cover dental illness in the Drugs & Dental optional coverage but many people found it expensive and hard to understand. So, we moved the dental illness coverage to our new Dental Rewards coverage, which is packaged with dental cleanings (more on this new coverage later this week). As a result, the Drugs & Dental optional coverage has been renamed by Prescription Drug optional coverage with a corresponding decrease in cost.
Coverage increase:
This is a biggie - we have removed the annual sublimit for continuing care issues. Now, any conditions, new or ongoing, comes under the full annual limit you've picked. We have added a new $50,000 lifetime limit. This is a wonderful improvement for our pet parents.
Clarification of our coverage:
We have now clarified that preventative sterilization surgery is excluded, such as for treatment for cryptorchidism, chimerism, or chromasonal abnormalities. We do not cover spay or neuter in our insurance coverage (it is covered in our Wellness Rewards coverage) but it was unclear what we do for preventative sterilizations surgery. While it's not covered in the insurance coverage, it is covered in our wellness coverage.

In addition to these insurance policy changes, we have also updated the Wellness Rewards coverage and added another coverage level - Wellness Rewards Plus. More details on the wellness coverage tomorrow.

I am really excited about all these changes. Most of them come in response to your comments and suggestions about our policy terms.

So you can thank your fellow Embraced pet parents for these delicious changes that will make your Embrace experience all the more better.

Download RLI terms and conditions 05.10
Download Declaration Page and Schedule of Insured Pets sample (these would be specific to you and your pets)

Posted by Laura on Monday, August 16, 2010 at 05:01 AM in Embrace Pet Insurance, Embrace products, passion for pets, pet insurance , pet insurance news, RLI Corp | Permalink | Comments (2)

Embrace has a new insurance partner - A+ rated RLI Corp

Drum roll please - a big moment for Embrace...

As of today, Embrace is selling RLI Corporation pet insurance policies in 23 states (see the list at the bottom of the post). We are in the process of rolling out all 51 jurisdicitions we work in, so if your state isn't in the list below, it will be soon.

Why are we changing insurance underwriters?
Our current underwriter, Lloyd's of London, has been wonderful for Embrace but we have outgrown them here in the US. This is not a surprise and we knew it was going to happen at some point and now the time has come.

We are very grateful and appreciative of the support and help our Lloyd's syndicate Brit has given us since well before we sold our first policy in 2006. We would not be here without their support.

Who is RLI?
I am absolutely delighted to partner with RLI Corp. Here are my top 5 reasons for partnering with RLI, from the most obvious down to the most important:

RLI is A+rated by AM Best, meaning that RLI has a superior ability to meet its ongoing insurance obligations - a most important characteristic if you want a company that is going to be there in the future when you need it the most.
RLI has been named as one of the insurance industry's top performing companies by the Ward Group for the 20th consecutive year. RLI is one of only five property and casualty insurers to have been recognized for excellence among 3,000 property and casualty insurers every year since the inception of the Ward's 50® Top P&C Performers in 1991.
RLI is a specialty insurance company serving niche or underserved markets. So they know how to handle nice marketplaces and knows what it takes to succeed.
RLI had an entrepreneurial start in contact lens insurance and still cultivates its entrepreneurial culture. This is very important to me because I want and need an insurance partner that is going to understand the entpreneurial culture at Embrace.
RLI has an amazing culture with strong people who are wonderful to work with. The people we are dealing with is the most important aspect of the Embrace partnership with RLI since these are the people we are "married" to in this partnership. Two separate companies working together as one is not as simple as it seems. Trust in, and respect for, one another is key and there is no shortage of trust and respect between us. That's such a relief for me on behalf of our Embrace pet parents.

Check out "What the new Embrace RLI partnership means for you" where I talk about the policy terms and conditions changes. We have a lot of policy enhancements I know you are going to like.

States that have converted over to RLI policies (for an up-to-date list, see the Embrace Pet Insurance website):

Alabama	Illinois	Maine	New Jersey	Texas
Arizona	Indiana	Michigan	Ohio	Utah
Arkansas	Iowa	Mississippi	Oregon	Wisconsin
Colorado	Kansas	Montana	Pennsylvania
District of Columbia	Kentucky	Nebraska	South Dakota

Posted by Laura on Monday, August 16, 2010 at 04:59 AM in Embrace Pet Insurance, Embrace products, pet insurance , pet insurance news, RLI Corp | Permalink | Comments (0)

Friday, August 13, 2010

Embracers really get into the pet obesity theme this month

No doubt about it, Embracers are taking on the obesity theme with gusto.

Lea, over at the Embrace Pet Community blog, is participating in the Nulo challenge. Nulo, a pet food company where "nutrition meets love", is a running a pet blogger challenge where several bloggers are working with Nulo to help their pets lose weight over the coming weeks.

The challenge starts next week and Lea and her dogs, Lyger and Lula, are participating. Read their stories here:

In addition, Sarah, one of our newest Embracers, asked me if she could introduce a wellness program to the Embrace family (the two legged ones this time), which I gladly accepted so we're waiting with baited breath on what she has in store for us (hopefully not 20 push ups before coffee - yes sir!)

And finally, I've decided that it's time I got back into some sort of fitness (young kids and entrepreneurial lifestyle do not leave much time for personal health) so I've started running. The last time I ran was when I trained to climb up Cotopaxi while I was at Wharton (back in 2002) and that nearly killed me. I am not an aerobic girl (although I was in the same gym once as Jane Fonda while she was doing aerobics but that's another story) so this is going to be hard for me. Thankfully, I have a lot of inspiration and encouragement online as a couple of my friends on Facebook are posting their running times so I'm doing the same (I'm using Daily Mile if you are interested - friend me there or on Facebook if you want).

Now's the time I wish I had a dog to run with...

Are you doing anything to improve your fitness or weight with your pets or just for yourself?

Posted by Laura on Friday, August 13, 2010 at 08:02 AM | Permalink | Comments (0)

Embrace Pet Insurance Blog

Tuesday, August 31, 2010

Claim Example: Inguinal Hernia Repair in a Dachshund

Monday, August 30, 2010

Measuring my cats' body mass index - the FBMI

Friday, August 20, 2010

Other interesting changes in the Embrace Pet Insurance policies

Thursday, August 19, 2010

Embrace Continuing Care Sublimits have gone!

Wednesday, August 18, 2010

Anyone interested in some Embrace Dental Rewards? Pick me, pick me!

Tuesday, August 17, 2010

The new and improved Embrace Wellness Rewards program

Monday, August 16, 2010

PennHIP Pet Insurance Discount now available at Embrace Pet Insurance

What the new Embrace / RLI partnership means for you - new terms and conditions

Embrace has a new insurance partner - A+ rated RLI Corp

Friday, August 13, 2010

Embracers really get into the pet obesity theme this month

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