Embrace Pet Insurance Blog

Embrace Continuing Care Sublimits have gone!

No more sublimit on the Embrace continuing care benefit for those Embrace policies with RLI as underwriter (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 limit is more than enough for any one dog or cat, don't you think?

So, what does mean for those of you with Lloyd's policies. To set the stage, there are 23 RLI states at the moment, with more coming every week (see Lloyd's and RLI states here). I can't guarantee when all the states will convert over but we're working hard to make it ASAP with a little fairy dust and Department of Insurance good will (please please please DOI ...)

[as an aside to those of you not in the insurance industry - you have no idea how inefficient the process of filing in 51 jurisdictions is (I'm being polite since I really want our policies to get approved!)]

But I digress...

In summary:

• If you bought a Lloyd's policy recently, likely 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 and you are in one of the RLI states, you also will have no continuing care sublimit (list of RLI states)
• If your renewal is coming up and you are in a Lloyd's state, chances are you are going to renew into a Lloyd's state and continue on with your policy as it is now (list of LLoyd's states). But when you renew in 2011, you will move to RLI at that time.

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?

Related Posts - move to RLI
Embrace has a new insurance partner - A+ rated RLI Corp
What the new Embrace / RLI partnership means for you - new terms and conditions
PennHIP Pet Insurance Discount now available at Embrace Pet Insurance
The new and improved Embrace Wellness Rewards program
Anyone interested in some Embrace Dental Rewards? Pick me, pick me!
Embrace Continuing Care Sublimits are gone!
Other interesting changes in the Embrace Pet Insurance policies

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.]

Related Posts - move to RLI
Embrace has a new insurance partner - A+ rated RLI Corp
What the new Embrace / RLI partnership means for you - new terms and conditions
PennHIP Pet Insurance Discount now available at Embrace Pet Insurance
The new and improved Embrace Wellness Rewards program
Anyone interested in some Embrace Dental Rewards? Pick me, pick me!
Embrace Continuing Care Sublimits are gone!
Other interesting changes in the Embrace Pet Insurance policies

Related Posts - Hip Dysplasia:
Hip dysplasia in dogs (and cats)
How much did you say hip dysplasia surgery cost for my dog?

Embrace claims stories:
Hip Dysplasia and Femoral Head Ostectomy
Liko's Hip Dysplasia Story

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.

1. 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!
2. 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.
3. 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.
4. Relaxation of terms:
   We removed the arbitration clause - RLI's legal group prefer it that way
5. Relaxation of terms:
   The claims submission period has been increased to 90 days, up from 60 days it used to be
6. 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.
7. 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.
8. 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)

Related Posts - move to RLI
Embrace has a new insurance partner - A+ rated RLI Corp
What the new Embrace / RLI partnership means for you - new terms and conditions
PennHIP Pet Insurance Discount now available at Embrace Pet Insurance
The new and improved Embrace Wellness Rewards program
Anyone interested in some Embrace Dental Rewards? Pick me, pick me!
Embrace Continuing Care Sublimits are gone!
Other interesting changes in the Embrace Pet Insurance policies

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

Woohoo! 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

Related Posts - move to RLI
Embrace has a new insurance partner - A+ rated RLI Corp
What the new Embrace / RLI partnership means for you - new terms and conditions
PennHIP Pet Insurance Discount now available at Embrace Pet Insurance
The new and improved Embrace Wellness Rewards program
Anyone interested in some Embrace Dental Rewards? Pick me, pick me!
Embrace Continuing Care Sublimits are gone!
Other interesting changes in the Embrace Pet Insurance policies

Claim Example: Cherry Eye in Koa, a Bulldog puppy

The English Bulldog is instantly recognizable by their wrinkly faces and barrel-chested physique. But, in the veterinary world, Bulldogs are notorious for their eye problems.

Dewey and Koa, both English Bulldogs in Newcastle, DE, were no exception. Starting out with a corneal ulcer in March 2009, Dewey was the first to have troubles. By May, he underwent surgery to correct Cherry Eye (also known by the convoluted name of prolapsed gland of the third eyelid), a painful condition in which the third eye lid is prolapsed, forming a red bubble in front of the eye.

Later that year, Dewey became a big brother when Koa came home. But poor Koa wasn’t even four months old when he was diagnosed with his own case of cherry eye. So, in he went for his own corrective cherry eye surgery, and follow up treatments.

Dewey and Koa are now back to normal, happy and healthy bulldogs again.

Dewey: Total cost for Cherry Eye Surgery: $524.07
Annual Deductible remaining: $0.00*
10 % Co-pay: 52.41
Reimbursement: $471.66
*Dewey had already met his annual deductible with prior claims for illnesses

Koa: Total cost for Cherry Eye Surgery: $626.22
Annual Deductible remaining: $200.00
10 % Co-pay: 42.62
Reimbursement: $383.60

Details on Koa's claim:
This claim is pretty typical of many Cherry Eye correction surgeries in that the correction was done at the same time Koa was neutered. Since Koa's insurance policy does not cover neutering (but our optional wellness plan does), the anesthesia was proportioned to 75% cherry eye correction and 25% neutering and covered accordingly (highlighted below).

ITEM	BILLED AMOUNT	ALLOWABLE CHARGES	COVERAGE TYPE	COVERED IN POLICY?	COVERED CHARGES
Triple Antibiotic Eye Ointment	$ 13.44	$     13.44	IL	Y	$    13.44
Additional Anesth. Maintenance/30 min.	$ 41.16	$     30.87	IL	Y	$    30.87
Neuter Canine 21-40 lbs	$   195.00	$ 195.00	RC	N	$   0.00
Hardarian Gland Tack	$   276.86	$ 276.86	IL	Y	$ 276.86
Surgical Ophthalmic Pack	$ 30.76	$     30.76	IL	Y	$    30.76
Inhalation Anesthetic Maintenance	$ 64.68	$     48.51	IL	Y	$    48.51
Intravenous Induction	$ 25.87	$     25.87	IL	Y	$    25.87
IV Catheterization-Surgical	$ 26.00	$     26.00	IL	Y	$    26.00
Pain Management Injection	$ 19.93	$     19.93	IL	Y	$    19.93
Pre Anesthetic Medication	$ 25.87	$     25.87	IL	Y	$    25.87
Examination (Pre-Anesthesia)	$    0.00	$   0.00	IL	Y	$   0.00
2.5 Novox 75 mg.	$ 17.55	$     17.55	DD	Y	$    17.55
5 Tramadol 50 mg.	$ 17.55	$     17.55	DD	Y	$    17.55
Soft Recovery Collar Canine 17 cm	$ 15.64	$     15.64	IL	Y	$    15.64
Canine H3N8 Influenza Vaccine, 1st	$ 25.00	$     25.00	RC	N	$   0.00
Tobramycin 0.3% Ophthalmic Soln 5 ml	$ 13.82	$     13.82	DD	Y	$    13.82
Recheck Visit-Brief	$ 32.66	$     32.66	IL	Y	$    32.66
14 Clavamox (Antibiotic) 125 mg.	$ 30.89	$     30.89	DD	Y	$    30.89
	$   872.68	$ 846.22			$ 626.22

So the total claim reimbursement was $383.60, which is calculated below (this is the detail we send out in our explanation of benefits):

STEP 1: Calculate Potential Refund
Billed Amount:								$ 872.68
Covered Charges:								$ 626.22
Annual deductible remaining								$ 200.00
	subtotal							$ 426.22
Copay 10%	(your copayment)							$     42.62
Potential Refund								$ 383.60
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:								$     383.60

Koa's policy ($200 annual deductible, 10% copay, $10,000 annual maximum, drugs and dental extension, no wellness coverage) costs $63.65 a month. Koa's premium is higher than many dogs because English Bulldogs have more hereditary conditions than most breeds, all else being equal.

Dr Janet Tobiasson Crosby will be writing more about Cherry Eye treatment and surgery in a blog entry next week.

Related Posts:
July is Eye Month at Embrace Pet Insurance
Claim Example: Cherry Eye in Koa, a Bulldog puppy
Cataract surgery claim example: Nala 2 yr old Papillon
Guest post: cherry eye treatment options
Guest Post: lens luxation in a Dalmation

Ask Laura: what happens to my Embrace pet insurance policy when I die

As they say, Death, while not a very savory topic of discussion, is one of the only guaranteed things in life. So, I thought it very interesting to get this thoughtful question from one of our policyholders, Reed C.

Question:

My husband and I are updating our Wills, and I am wondering, in the event of my death, would my Embrace policies be automatically cancelled? I would like to know what would happen to the policy were I to die and my husband would survive me --- would it continue as long as paid the premiums? He is currently not named in the policy. Can we arrange for this?

Secondly, were my husband and I both to die simultaneously, we have made arrangements for my sister to take both Otis and Gracie. Would the policy continue with her? If not, can we arrange for that?

I know this isn't the most pleasant topic, but we are dedicated to our pets, and want to plan for them should the worst happen. Thank you in advance for your help.

Answer:

Reed, what a thoughtful question!

If the named policyholders died (currently you but we can add your husband – more on that later), we would just continue the policy until further instructions from the estate. In your case, you’ve put instructions to transfer to your sister so we would honor that without a break in the policy; however, if she decided to cancel the policy after that, we would have to honor that too.

If you’d like to add your husband as a named insured, just call in (800 511 9172) or email me with his name and we’ll have him added. He’ll have the same powers as you over the policy, including to cancel it. You would be notified if the policy was cancelled by him of course!

Got any other questions on estate planning for your dog or cat?

North American Pet Health Insurance Month is coming up - get your entries in!

I can't believe it's that time again but Pet Health Insurance Month is coming up in September! The North American Pet Health Insurance Association (NAPHIA) is sponsoring the event across the US and Canada.

Time to dust off your story telling submit your pet insurance claim stories and nominate your favorite veterinarian for some great prizes, including $1,000 for you and a grant for your veterinarian. You can do it!

The 2009 pet insurance story was Heimdall's battle with a rare type of pneumonia that cost more than $10,000.

Last year's winning veterinarian was Dr. Wayne Ingmire of Chicago, IL.

Check out the details over at NAPHIA.org.

Great example of using your Embrace Wellness Rewards benefits

Over at the Embrace Pet Community blog, Lea recently posted about going online to save some money for her flea and tick preventative medication for Lyger.

It was so easy to squeeze out the most benefit from her wellness budget by shopping online (muchos dollares saved there) and by using the Embrace wellness plan (spreads the cost out over the year and saved $21!).

I like this bit best though :) :

And, since I use Embrace's Wellness Rewards program, to cover Lyger's checkups, vaccines, and preventative meds (even meds bought online) I'll be reimbursed $200 for today's costs!

Check out the rest here: Saving money on flea and tick medication

Cancer claim example: Grade III Mast Cell Tumor

Miel was 6 years old when Nisha discovered he had mast cell tumors on his neck, collar bone and right leg. Through ultrasound, she also found out that Miel had enlarged nodes internally as well.

Mast cells are the cells in the skin and connective tissue (among other places) and play a protective role in wound healing, a well as inflamation in allergies and analphylactic shock.

Grade III mast cell tumors are the most aggressive of mast cells tumors (Grade I being the least) and are the most likely to rapidly metastasize. This grade of mast cell tumor is the least common but also the most deadly.

Miel's cancer treatment lasted 6 months, including one surgery and at least seven rounds of varying types of chemotherapy treatment. The skin masses appeared to improve over that time; however, the cancer spread further inside Miel's intestinal area, severely narrowing his rectal passage and finally his urinary tract, forcing the decision to euthanize Miel at the end of his brave cancer battle.

Nisha was a medical student when she bought Miel's policy (when he was 5 years old), figuring she really didn't have any spare cash if something expensive should happen to Miel.

Embrace Pet Insurance Policy: $200 annual deductible; $5,000 annual maximum; 20% copay; prescription drugs covered. Monthly premium $35.90

Miel's cancer treatment costs at a veterinary clinic in Washington DC in 2008 were a total of $5,659.37 with pet insurance reimbursement of $4,367.50 (=$5,659.37 - $200 deductible * (1 - 20% copay).

___________________________________

Are you about to go through cancer treatments with your dog or cat? If you would like to share, we'd all like to pass on our positive thoughts for your pet's strong recovery.

Related Articles:
April is Cancer Month at Embrace Pet Insurance
Guest post: veterinary thoughts on dog and cat cancer
Cancer claim example: Grade III Mast Cell Tumor
Cancer Claim Example: Anal Sac Apocrine Gland Adenocarcinoma
Rates of Cancer by Dog Breed

Canine genetic condition: Distichiasis and Ectopic Cilia

Distichiasis and ectopic cilia are relatively common genetic conditions of eyelids in dogs. Abnormal hair grows in the eyelids and can poke out onto the outer edge of the eyelid  (distichia, generally not painful)or inward onto the cornea (ectopic cilia), which can be very painful for the poor dog that suffers from this condition.

Dogs with this conditions have all the symptoms of uncomfortable eyes such as tearing, blinking, redness and conjunctival infections, which can progress to corneal ulceration and worse case, loss of vision due to corneal scarring and eye loss if treatment isn’t sought. 

Treatment isn't cheap - about $1,500 to $2,000 for "cryoepilation", where the vet freezes the offending hairs and pulls them out. Definitely something you'd want pet insurance to cover!

The dogs that are most affected are Shih Tzu's, but looking at Embrace claims, we've seen it in other breeds such as English Bulldogs, Brussels Griffon, Clumber Spaniels, and Pomeranians.

What has your experience been with these conditions?