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Avoiding the Winter Blues

Winter weather brings a host of insurance risks to homes and businesses, from ice dams wreaking havoc on a building’s interior to frozen and burst pipes causing serious water damage, to liability issues if someone falls on the ice on the front sidewalk. Insurance policies help protect property owners against exposure to such events, but just as important are common-sense preparations to minimize such risks in the first place.

John Dowd Jr. remembers 2011 well. That’s the year that brought Western Mass. a tornado in June, a tropical storm in August, and the out-of-nowhere snowstorm in late October. It was, in short, a rough year for insurance claims.

But the first rush of claims arrived in February, recalled Dowd, president and CEO of the Dowd Insurance Agencies in Holyoke. That was when a constant barrage of snows and thaws built up ice dams along countless homeowners’ rooflines, many breaking through the walls and dousing the interior with water.

“Ice dams are nothing new; it’s the confluence between snowfall and warming temperatures that create the backup,” he said. “That year, it was especially bad, coming after heavy snowfalls and creating enormous claims. People had situations where water was literally pouring into their living room.”

That’s especially true of older homes, he added, as many newer houses are built in a way that minimizes the flow of warm air into the cracks that fosters the growth of ice dams. However, while the damming phenomenon is nothing new, what has changed is insurance companies’ tolerance for paying for the damages, he went on.

SEE: List of Insurance Agencies

“There’s a national database of claims histories that insurance companies can access. If you’ve had claims, they ask you what steps you’ve taken to keep this from happening again,” Dowd explained, citing options from professionally installed electrical wiring on the roof to plastic panels designed to prevent dams from forming. “And if you haven’t taken those steps, in some cases, insurance companies are not going to insure you.”

While some of those remedies, like the wiring, aren’t cheap, he added, no one wants to go through an ice-dam experience — not the insurance company, and certainly not the homeowner, who must grapple with interior damage and loss, and perhaps mold issues down the line.

David Matosky, operations director at First American Insurance in Chicopee, noted that standard homeowners’ insurance typically covers damage to a structure as a result of an ice dam, but will not cover the expenses to eliminate or prevent the root cause of the ice dam. It also will not cover water damage to the contents of the structure as a result of the dam, though customers can check with their agent to see if they can add such coverage.

David Matosky says home and business owners can avoid winter-related claims by taking some strategic steps.

And it’s a growing concern at a time when the climate seems to be changing — check out all the leaves still on trees a week into December — and temperatures that fluctuate between freezing and balmy. Those kinds of conditions with snow mixed in are fertile ground for ice dams. “That’s when you get big problems,” Dowd said, “so it’s smart to invest in some kind of protection.”

In fact, ice dams are far from the only winter hazard that concerns homeowners, business owners, and insurance companies alike. And, like the dams, most of those hazards can be anticipated, and steps taken to minimize the risk well in advance.

“Make sure your attic is properly insulated,” Matosky said. “Take the time now to buy a shovel and roof rake, not after you’ve gotten 15 inches of snow. And you have to be consistent and clean snow from the roof on a regular basis, as long as it’s safe — we don’t recommend people going up on a two-story house to clear snow, so maybe bring in a professional who knows how to do it. If you have damaged singles on the roof or the drip guards are in need of repair, take care of that now, before the snow starts falling.”

After all, insurance professionals say, buying coverage is just one element in protecting one’s assets from seasonal damage; the other is simply common sense and preparation.

People Get Ready

Matosky noted that, while it’s good to have insurance, filing a claim is never an enjoyable experience.

“There’s a distinction between a loss and claim. A loss is when something bad happens; a claim is where you’re able to have the loss paid for,” he said. “In some events, you may have a loss but not have a claim, and you’re left holding the bag.”

That’s why the best way to prepare for winter events is to take the necessary steps to minimize the chances of a loss in the first place, he said. That means not only buying a roof rake before the snow season begins, but also maintaining and testing snow-blowing equipment before a blizzard kicks up. “One of the worst things is getting 12 inches of wet, heavy snow, and you go to start your snowblower, and it doesn’t start.”

Dowd’s agency recommends several steps to prepare for winter, advising clients to insulate the pipes in their crawlspaces and attic, as exposed pipes are most susceptible to freezing, and to seal air leaks, not only to improve the home’s heat efficiency, but to protect the pipes. With severe cold, even a tiny opening can let in enough cold air to cause a pipe to freeze; and

Also, before winter hits, homeowners should disconnect garden hoses and use an indoor valve to shut off water to the outside, then drain water from outside faucets to reduce the chance it will freeze in the short span of pipe just inside the house.

Be Aware of
Indoor Risks, Too

With fires and space heaters for warmth, candles and holiday décor for ambiance, and more indoor cooking and entertaining, the risk for fires in homes increases exponentially in the colder months. The Dowd Insurance Agency in Holyoke offers these helpful tips to keep in mind:
• Be sure your chimney is inspected and cleaned regularly based on how much you use it, and ensure the flue is open before you light a fire.
• Candles should not be left to burn unattended, or within easy reach of children, pets and flammable materials like curtains and holiday decorations. The same goes for space heaters.
• Take care not to overload electrical outlets with holiday decorations or small appliances like space heaters.
• Do not leave items on the stove unattended, and keep towels and other flammable materials away from the cooktop.
• Be sure you have a fire extinguisher easily accessible in your home, and that you know how to use it.

Power loss after a storm is another hazard, which is why Dowd recommends people have a backup generator easily accessible, so they can at least run the heat, their refrigerator, and a few lights. He recalled the freak October 2011 snowstorm that felled trees and power lines throughout Western Mass. and knocked out power in some communities for extended periods.

“We had no lights, no heat for a week in my house, and I didn’t have a generator, so we just lived without power,” he told BusinessWest. “We felt like we were pioneers.”

Loss of power can also cause pipes to freeze up, which is especially dangerous for people who head down south for vacations during the winter. Fortunately, Dowd said, technology is available to alert people remotely when temperatures drop in their home. Even so, he added, it’s a good idea to shut off the water main before leaving for an extended time, so if power shuts off and the pipes freeze and break, the water damage in the home will be minimal.

Other holiday risks may not be so obvious, such as the possibility that thieves are scoping out houses that may be stocked with Christmas gifts. Dowd recommends shutting the curtains at dusk to prevent would-be burglars for scoping out what’s in the house, or using a timer for indoor lights while away so the house doesn’t look empty, or installing motion-sensor lights outdoors as a deterrent. Such a device, or, even better, a complete security system, may qualify for a discount on the homeowner’s insurance policy.

Staying Upright

While water and fires can cause tremendous damage in a home, there are other hazards that increase during the colder months as well. One of the most important is the liability risk from slips and falls on driveways and sidewalks that may not be completely cleared of ice and snow, or properly de-iced or sanded, after a weather event.

“That’s an issue for commercial properties as well as landlords and homeowners,” Matosky said. “Most towns have ordinances that you have to remove snow and ice from your sidewalk at the end of a storm.”

And that means keeping it off, both with additional shoveling or plowing as necessary and with ice-melting agents. “And if the commercial property is hiring someone to do the snow removal, they should make sure they have the correct coverage; if they don’t plow or shovel correctly, and someone falls, they need to make sure they have the coverage to respond to such a claim.”

Property owners with steeply pitched roofs often have to worry about snow constantly falling as the weather warms after a storm, and they could be liable if snow or ice falls on a passerby, so they need to take a combination of steps, from clearing snow regularly, if possible, to simply posting signs or barricades to keep people out of danger spots.

Meanwhile, with more homes and businesses installing solar panels on the roof these days, there’s also the danger of sheets of snow sliding off those panels onto the ground below.

A lot to think about? Sure, but planning ahead for the winter weather — and responding quickly after a storm — can go a long way toward avoiding the types of losses and claims that cause headaches for property owners and insurers alike.

“We’re conditioned in our business to think of the worst-case scenario — what could happen? — and then develop a disaster plan,” Dowd said. “These things probably won’t happen, but they may happen, and you want to do all you can to mitigate the damage.”

Joseph Bednar can be reached at [email protected]

At Encharter Insurance, No Two Customers Are the Same

By BusinessWest Staff September 5, 2017

Insurance Sections

Risk and Reward

The Encharter management team, from left: Trish Vassallo, personal lines director; Beth Pearson, commercial lines director; Tracey Benison, president; and Sue Henry, vice president of finance and administration.

Tracey Benison, president of Encharter Insurance in Amherst, says she deals in what some people may consider a dry topic, or ‘white noise.’ But to her and her team, it’s actually a vibrant, highly personalized process of helping people recognize the risks in their home and work lives, reduce those exposures, and make sure they’re well-covered when the unthinkable happens.

Trish Vassallo says there’s a certain gratification in matching insurance clients to the right coverage, especially when the worst — anything from a destructive hurricane to a violent car crash — happens.

“The best thing we can tell them is, ‘you’re covered for that,’” said Vassallo, personal lines director at Encharter Insurance in Amherst, and a 25-year veteran with the agency. But getting to that point takes time and communication, because each client is different.

“It’s really important to talk to the customer and understand what risks might be hidden, what they might be unaware of,” she told BusinessWest. “They may say, ‘I don’t drive for work, but I drop the kids off on the way to work, and do the same for my neighbors.’ That opens the door to further questioning, and we make sure they have the right coverage.”

Tracey Benison, who came on board as Encharter’s president two years ago, agreed, noting that the firm’s customers range from individuals with $500 policies to business owners whose premiums reach eight digits. “Basically, everyone who walks through the door has unique exposures we need to address. So we learn what’s unique about them and make sure they’re absolutely covered. A lot of people underestimate what their insurance needs are, and underestimate the need to get guidance from an experienced adviser. A lot of people are focused on prices and don’t purchase the right coverages.”

She said real-life examples are plentiful, including one individual she knows who had $20,000 in liability coverage on his auto insurance, and hit a pedestrian in a crosswalk; the victim racked up $350,000 in medical care.

SEE: List of Insurance Agencies

“People say, ‘give me the best price,’ but they’re being penny wise and pound foolish,” Benison added. “And it’s not just the financial impact, but the stress. We want people to understand what their exposures are and what the best products are for it, and have them make a decision from there.”

The agency, formerly known as Blair, Cutting & Smith, traces its roots in Amherst back to 1879. In 1999, the firm was purchased by Plymouth Rock Assurance Corp. and changed its name to Encharter.

“But we remain independent, and we write as independent agents, but we work under the guise of Plymouth Rock, and we represent multiple carriers,” Vassallo said. “We don’t feed clients specific companies, but we look for the best product at the best price.”

Benison noted that many of Encharter’s 25 employees have been with the agency for many years, but plenty of new blood has come on board, including eight hires in the past year alone.

“It’s a growing office, and we want to keep growing,” she said, noting that 17 team members are licensed insurance agents. “That’s the majority of our staff, and to me, that’s a big part of what we do. When people walk through the door, anyone can help them with their insurance needs.”

What’s the Risk?

Encharter has long been a multi-pronged agency, offering a raft of products in both personal and commercial lines. On the personal side, customers cover everything from home and condo insurance to life insurance; from auto coverage to boats, motorcycles, even golf carts.

“We’re partnered with more than 50 carriers, which allows our customers to have access to a broad range of choices,” said Beth Pearson, commercial lines director.

But insurance isn’t just about making sure risk exposures are covered; the process begins with lessening those exposures to begin with, a process known as risk avoidance. “Insurance should be the last stop in the process,” Benison noted.

“One of the great things we do is educate people on exposures they might not be aware of,” Pearson added, noting, for example, that many commercial clients don’t comprehend the scope of today’s cyberthreats and the possibility of data breaches.

Tracey Benison says people who shop online for insurance, focusing only on price, are missing out on the personalized advice that could save them major headaches later.

“That’s a very interesting phenomenon in the marketplace. Cybercrime and ransomware and stealing data are becoming more sophisticated, and our client base does not necessarily know how to protect their business from these cybercriminals and hackers. In the fall, we offer a cyber presentation in conjunction with the chamber of commerce because people don’t always understand what’s involved in cyber risk and ransomware.”

As for insuring personal property, everyone is different, Benison said. “You can put two identical homes side by side, but the risk for each of them is different. It could be because someone is working from home, or it could be a piece of jewelry or an antique. That’s why purchasing insurance online is a problem. There isn’t someone going to the next stage, giving them advice on exposure. Instead, it’s ‘get the minimum possible, get the sale, and move on.’

“Commercial insurance is the same,” she went on. “You could have two electricians side by side, but one does commercial work and one does residential, or one has employees, and one doesn’t. You have to look at what they do, where they do it, and how they do it, and help them find ways to protect themselves and their assets.”

That said, Pearson noted, it’s gratifying to become a trusted adviser to someone taking a risk and starting a business. “We see a lot of new business owners, people starting a contracting business, a day care, a restaurant, and we have the opportunity to help all those folks open doors and help them as their business grows. We become their partner for a long period of time.”

Clearly, matching a client with an insurance product isn’t just a numbers game at Encharter.

“Insurance is a contract — very specialized, hard to read, and a lot to understand, and customers need to have it interpreted for them,” Benison said. “You can buy a policy from X and a policy from Y, and they cover very different things. People sometimes don’t spend the amount of time they need to really know what’s being covered or not.”

With an eye on further growth, Benison has also led a push to forge affinity agreements with area educational institutions, banks, credit unions, and nonprofits.

“Essentially, we find groups of people with a need for insurance and deliver that,” she said. “We’re finding a lot of employers aren’t addressing the insurance needs of their employees. So that’s an easy way for us to grow our business as well as meet a need on their behalf.”

Meanwhile, Encharter has also ramped up its continuing-education efforts for employees. “A lot of agencies won’t pay for that, but we do encourage and support it,” she told BusinessWest. “I want people continuously learning. Ten years ago, cyber wasn’t even an issue. Drones — that’s a new thing. And driverless cars will be the next thing we’re talking about. The exposures are forever changing, and we need to be on top of it.”

Community Ties

It’s not surprising that an agency whose hometown roots go back 138 years makes a priority of community involvement. Encharter does so through support of organizations like the Boys and Girls Clubs of Amherst and Springfield, Hitchcock Center in Amherst, Family Outreach of Amherst, and the Amherst Block Party. It will sponsor an Amherst Survival Center event this fall, and will be the lead sponsor on the 2017 Festival of Trees in Springfield. And a couple of weeks ago, at a new-teacher orientation at a local middle school, agency employees handed out backpacks filled with coffee cups, Dunkin’ Donuts cards, pencils, and other items to welcome the educators.

Some of those efforts are management decisions, but the agency also boasts an employee-run committee that meets once a month and targets organizations to support with fund-raisers like dress-down days; Plymouth Rock matches the donations.

“We’ve sponsored swimming lessons for students, the MSCPA, the Survival Center, and this month, Berkshire Children and Families,” Vassallo said. “They’re empowered to come up with that list for the whole year, not the corporation or management.”

Encharter traces its roots in Amherst back to 1879.

The company also tries to tie its community offerings back into its core business; a good example is Distractology, a week-long program created by Arbella Insurance. “We’re bringing it to Amherst High School — essentially, they will be training high-school seniors on defensive driving for a whole week.”

It’s one way to stress that concept of risk avoidance in an era when 25% of all car accidents involve a smartphone, Benison said. “I drive around, and I see a lot of accidents, and I have to think it’s highly likely that some of them are because someone was looking at their phone — and it’s avoidable.”

Encharter will also be offering educational seminars in the community on risk-exposure topics, she said. “We’ll try to find a way to make it interesting. Most people think of insurance like white noise. We want to provide information in a way that resonates, is meaningful, and prompts people to take action.”

It’s the kind of material the firm already shares on its blog, another way it continually reaches out into the community to help people make the kind of changes that will make insurance claims less likely. “There’s a lot of good information in there, as simple as changing the batteries in the smoke detector, or clearing snow from the gutters and off the roof. Hurricane season can be a scary time as well; we want people to be out in front of it, so they understand what they should be doing now.”

Pearson was quick to add that making connections extends to the Encharter team itself, which enjoys many employee-appreciation programs throughout the year for going above and beyond in their work.

“There are a lot of benefits of working here at Encharter,” she said. “I’ve had the opportunity to work at several other agencies, and Encharter is not only very generous, but thinks more about driving business toward the future, not just resting on its laurels.”

Such efforts will certainly help ensure its continued success in the town it has called home for almost 150 years.

Joseph Bednar can be reached at [email protected]

Risk Management Is Key to Avoiding Insurance Claims

By BusinessWest Staff May 16, 2017

Insurance Sections

Culture of Safety

Mention insurance to someone, and chances are they’ll think of buying a certain level of coverage against loss, damage, or other adverse events. But when it comes to business insurance, that’s just one aspect of protecting a company. Just as important is risk management, which is essentially the process of implementing steps to reduce the probability of such dangers. It’s a win-win effort that saves money for both insurance companies and their clients — and often saves lives, too.

Insurance, Bill Grinnell noted, is a transfer of risk, an investment a business makes in protecting itself from the costs of accidents, fraud, theft, and any number of other occurrences.

“You can manage risk in different ways,” said Grinnell, president of Webber & Grinnell Insurance in Northampton. “You can buy insurance to protect against exposures, but you can also reduce the risk of exposures — and your costs will be lower.”

He was talking about risk management, which can take many shapes, but typically refers to the mitigation of risk to avoid an accident or other incident that could trigger a costly insurance claim.

Risk management is big business for insurance carriers, who employ professionals with industry-specific expertise to help businesses cut down on their exposure to risk, thereby saving both the insurer and client money.

Bill Grinnell says reducing risks is the best way to lower the cost of insuring against exposures.

“Some of it is common sense. But sometimes it takes paid professionals to come in and make recommendations to help devise solutions,” said Timm Marini, president of HUB International New England in East Longmeadow. “The larger employers have their own safety officers and risk-management officers, but even they often rely on people like us.”

He said one of HUB’s calling cards is its network of individuals around the country who develop and help implement industry-specific workplace strategies to reduce risk, from driver training to hazardous-materials edcuation. “Within each discipline, there are very specific types of expertise available.”

Shellye Archambeau, CEO of MetricStream, a provider of governance, risk, and compliance software solutions, recently wrote that the hallmark of a good risk-management program is a pervasive risk-assessment culture that starts at the top, and is built on sound policies, training programs, and incentives.

“For organizations to not only survive, but thrive in this new landscape, they will need to build better resilience. That means gathering, analyzing, and learning from the past, so that decision makers can take measured steps to deal with the next major volatility or stress,” Archambeau noted. “It also means having the right risk data at the right time to understand how to diversify or disperse risks, so that no single risk has a major impact.”

The exposures that HUB works with companies to mitigate, Marini told BusinessWest, are diverse and always changing. For instance, while many accident-prevention strategies in manufacturing have been around for decades, now employers must deal with a demographic shift: Americans working longer in life than before, leading to higher-than-ever instances of joint deterioration and a subsequent boost in workers’ compensation claims related to joint injury and replacement.

Then there’s the new high-tech culture as it intersects with driving, a concern for companies with employees who work on the road. “With new technology in vehicles, we’re seeing more distracted drivers,” Marini said. “That creates increased exposure; when drivers get distracted, it’s very similar to drunk or impaired driving.”

SEE: List of Insurance Agencies in Western Mass.

Grinnell agrees, saying, his agency insures many firms in trucking, fuel-oil transport, and other fields where driver safety is a concern. “So we’re seeing more webcam technology, GPS technology, and technology that tracks the speed of the vehicle, sudden starts and stops, swerves … all that gets recorded.”

It’s a way to both incentivize driver safety and to record the true facts of an accident, both of which affect a company’s bottom line. But another high-tech concern is causing an even greater stir these days in the world of risk management.

Breach Combers

That would be cybersecurity, an area of interest for just about every company, large or small. Not every breach causes exposure on the level of a Target or Home Depot, but any avoidable damage can harm a company’s bottom line and reputation.

“Those companies that keep medical records, Social Security numbers, and credit cards are expected to be more diligent in protecting their data than businesses that don’t have so much of that exposure,” Grinnell said. “You need to be sure you’re not only protected, but in compliance with some pretty stringent laws.”

More and more, Marini added, insurance agencies are working with clients to control cyber privacy and protect information. “It runs the gamut from healthcare to manufacturing. If people get in, they can disrupt your business and hold you hostage. We’re spending a whole lot of time developing capabilities to help our customers protect themselves from cyber exposure and risk.”

Timm Marini says technology is posing new risks, from data breaches to drivers distracted by their devices.

One way it has done that is through the use of certified friendly hackers. “We’ve actually put on some seminars with the FBI, where our friendly hacker goes in and shows how easy it is to permeate your firewalls. For 97% of businesses, it’s not a matter of if, but when something of this nature will happen.”

But he also returned to that concept of creating a culture of safety where each employee understands the risks of, say, leaving a laptop open, neglecting strong password protection, or falling for phishing e-mails. “Those moments of carelessness may be having the same password for everyone, or keeping printed materials of a private nature in your vehicle.”

After all, employee negligence may limit insurance protection, noted Lorelle Masters, a partner at the international law firm Perkins Coie, in Risk Management Monitor. “Although many businesses have crime insurance that covers ‘computer-systems fraud,’ ambiguous provisions or liability limits may restrict coverage,” she noted. “Some courts have held that fraud coverage applies only when intrusions are unauthorized, but not when an unwitting employee falls prey to an online scam.”

For other types of risk exposure, insurance companies rely on the guidelines laid out by the National Fire Protection Agency, the Occupational Safety and Health Administration (OSHA), and other work-related protection agencies — as well as their own, industry-specific expertise — to determine exposure to loss and help companies reduce it.

For instance, manufacturers need to train employees in handling hazardous chemicals and working around dangerous machinery and sharp cutting edges. Much like the friendly-hacker concept, many risk managers conduct mock OSHA inspections, so companies can locate and iron out safety issues before the real thing — when mistakes can lead to hefty fines. Businesses may also choose to make structural changes to their buildings if they’re located in a flood zone, near a faultline, or otherwise geographically vunerable.

Once risk is mitigated to whatever degree is possible, an insurance carrier can then assume the remainder of the risk.

“Risk management boils down to the owner and management of a business making safety a priority and really instilling in their managers to preach safety — and hold them accountable for the safety of their workers,” Grinnell said. “It’s amazing how much common sense can protect a business. On the other hand, if it’s all about profit and productivity and squeezing as much business as you can into one day, then safety falls to the side, then accidents are going to happen. When businesses get the culture of safety right, the rest kind of falls into place.”

Stepping Up

Grinnell noted, however, that many insurance companies do a mediocre job helping companies reduce risk. “Most insurance companies go out for the first visit and make sure companies have their act together, but they don’t repeat that visit or check up on them,” he said. “Some companies do offer more comprehensive risk-management services, but they’re few and far between, so companies are left to rely on their own devices to figure out their risk-management steps. We do offer a fair amount of those services.”

With the risk-management and regulatory-compliance worlds intersecting in a more complex way for businesses these days, Marini said HUB’s emphasis on providing resources to help clients navigate their risks is a definite benefit. “We have all of that available for our customers. Ninety-nine percent of the time, it’s part of the arrangement.”

Some risk-management startegies are simply common sense, from not leaving customer data lying around to shredding rather than throwing away sensitive documents; from maintaining eye-wash stations where chemicals are handled to installing cameras in parking lots and entryways to record the verity of slip-and-fall accidents that often lead to costly lawsuits.

“Those types of controls have been around for a long time,” Grinnell added. “You basically do an assessment of the business, whether you’re trying to prevent hands getting caught in machines or exposure to hazardous materials or fall exposure, whatever. There are safe practices to follow to protect yourself against all those hazards.”

Although no company can ever say it’s totally safe from the myriad events that cause disruption, financial loss, and injury — or worse — it’s clear that developing that culture of safety, with all the details that go into it, can significantly reduce exposures and help employers sleep better at night.

“You may think you’re running the best operation in the world,” Grinnell said, “but if you’re not thinking about these exposures, you’re leaving yourself vulnerable.”

Joseph Bednar can be reached at [email protected]

Wilcox Insurance Takes a Proactive Stance to Improve Customer Service

By BusinessWest Staff October 18, 2016

Insurance Sections

Mitigating Risk

Robert Wilcox says the Team Concept program within Wilcox Insurance Agency has proved beneficial to clients.

While acknowledging that all insurance agencies strive for solid customer service, Robert Wilcox, the fourth-generation owner of the family business that bears his name, says he takes such efforts seriously, whether it’s monitoring how claims are handled, closely assessing risk to determine what clients need (or don’t need), or even running out to house fires at night. The goal, he said, is to use his experience to help others — and, in doing so, to help his agency stand out in a crowded field.

The call came at midnight.

Robert Wilcox was in bed, but when he heard the Westfield Fire Department was battling a blaze in a client’s multi-family house, he got up, went directly to the scene, and worked with the Red Cross to find a hotel to house the displaced tenants and answer all of their questions.

“I wanted to be right there; when a tragedy occurs, it’s part of my job to help people find some sort of peace of mind and comfort, reassure them that everything will be OK,” said the fourth-generation owner of Wilcox Insurance in Westfield and Agawam, adding that a second major fire had occurred a few days earlier, and he also went directly to that home.

In another instance, Wilcox went to battle for a client when an insurance claim was denied in a highly unusual situation. He told BusinessWest a tenant had died on the second floor of a two-story building, and there was more than $30,000 of damage as blood and body fluids had ruined the floors and carpeting and the stench permeated the unit.

“The insurance carrier tried to deny the claim on a pollution exclusion in the policy,” Wilcox said. “But I argued that it wasn’t pollution and got them to pay the claim.”

He cited a number of other situations when he went to bat for clients and won, including times when auto insurers didn’t want to pay for expensive parts needed to repair a vehicle.

“My goal is to do the right thing. Fighting for a client can involve a lot of frustration, but it’s worth it when I can hand them a check that relieves their anxiety,” Wilcox continued.

The father of six children aged 5 to 17 is very active in both the community and the insurance industry, and when the interview began, he immediately acknowledged that all insurance companies work hard to provide excellent customer service.

See: Insurance Agencies in the region

But rather than focusing on competitors or what the market is doing, Wilcox takes a different approach to business by focusing on how things are handled within his own agency, which ranges from monitoring phone calls and how claims are handled to alerting customers when changes need to be made to their policies or things such as accident forgiveness come into play, to closely assessing risk for new commercial clients by taking the time to understand exactly what they do and their ensuing exposure to risk.

“The ultimate purpose in life is to use your experience to help others. It’s all about being helpful, which is my goal,” Wilcox said.

For this issue and its focus on insurance, BusinessWest looks at the history of this family-owned company and the creative measures that have been instituted to ensure the agency continues to thrive in a time when polices sold via the Internet, or through TV ads generated by direct writers such as Allstate and Nationwide, have made competition especially fierce.

Storied History

Wilcox’s great grandfather, the late Raymond Wilcox, was a tobacco farmer before he founded Westfield Mutual Insurance Agency Inc.

The reason for his career change was devastation: his farm was hit by two hailstorms, and although he recovered from the first one, the second one marked the end of his business.

“At that point, he began knocking on doors and selling insurance,” Robert said, adding that Raymond opened his own insurance firm on Sept. 1, 1923.

In 1937, he was joined by his son, Malcolm Wilcox, and during the ’40s and ’50s, the agency underwent remarkable growth.

“My father, Scott Wilcox, came on board in 1962, and when I started in 1990, my grandfather was still working,” Robert recalled, adding that, when his dad retired in 2012, he bought the business from him.

His own entry into the firm came when he was a college student. He was living independently, and when he found he was $40 short of meeting his expenses each month, he called his father to ask for help and was told to show up at the agency on Monday morning.

Wilcox said he began working part-time, and has been at the agency ever since. He literally started at the bottom, sweeping the basement, and continued his college career while he worked, eventually earning an associate’s degree in business studies from Holyoke Community College and a bachelor’s degree in finance from Westfield State College.

Wilcox earned his license to sell insurance in 1993, and as his love for the business grew, he became active in the industry. Today, his history of service includes stints as president of the Independent Insurance Agents of Hampden County and the Massachusetts/Rhode Island User Group of Applied Systems.

In 1997, Wilcox and his father purchased Pomeroy Insurance Agency and Clem Insurance Agency, followed by Palczynski Insurance Agency in 2000. All three of these businesses were in Westfield, and in 2002, the name of the agency was changed to reflect how most of clients referred to the them, as well as the fact that they wrote so much business outside of Westfield.

“We didn’t want our image to limit our reach to Westfield only,” Robert said. “It also fit our goal to acquire other agencies outside of Westfield.”

Members of the Team Concept program get together each month and go over practices that need to be continued and others that can be improved in order to provide the best service possible to customers.

In 2005 he built a new office for the company at its present location on Broad Street. The following year he acquired Foley Insurance Agency in Feeding Hills, and four years later he built a new office in Agawam to provide service for his agency’s new customers.

“My focus is on growth through acquisition, and I hope to be able to acquire additional agencies,” he told BusinessWest, adding that he has great respect for the companies he’s purchased.

The cornerstone of his own success is based on applying knowledge gleaned from personal experience and certifications to make sure each client has the coverage they need to fit their individual situations.

To that end, Wilcox and his employees inform current clients about any changes they may need to make to their policies, and spend an unusual amount of time working to determine exactly what each new client needs, which is especially important for commercial accounts due to their differing operations.

“You need to understand everything a business does, in addition to conducting a survey of their equipment and property,” Wilcox said, adding that he is a certified insurance counselor and licensed insurance advisor, and although few people in Western Mass. hold that designation, he chose to pursue it to increase his knowledge of risk assessment.

To that end, he learns all he can about a business and how it operates to make sure policies don’t contain exclusions that could prove costly. For example, a business that cleans carpets on site and offers storage needs accident coverage that doesn’t exclude the property of others.

The goal is to serve the client in the best way possible, and in some cases a close investigation can result in lower premiums. For example, Wilcox gained a client after talking to him about the 20-plus buildings he owned that contained 127 residential units.

“He had been told that he had to carry insurance on all of the buildings and wanted to know if he could self-insure the structures he owned outright,” Wilcox said, explaining that, although he needed liability insurance for every rental property, he did not need to insure buildings without a mortgage.

Since the prospect wasn’t concerned about losing buildings he owned to fire or other catastrophic events, he was able to save thousands in premiums.

“We are not a hard-sell agency; our approach is to build relationships and protect assets by understanding the client’s exposures and tailoring coverage to meet those needs,” he explained.

Innovative Change

Eighteen months ago, Wilcox devised a pilot program based on leadership that he designed to increase responsibility, determine practices that work well and should be continued, and examine instances where change could result in better customer service.

The program is called the Wilcox Service Team Concept, and four key account managers take turns acting as the team leader through a monthly rotation process. There are guidelines that promote objectivity and prevent judgment from occurring as they review situations that occurred during the month.

“It’s easy for employees in a small office to focus on what others are doing instead of looking at their own work,” he explained. “But our team works together for the betterment of clients.

“We focus on excellence; everything that is discussed is considered a teaching moment and is brought up from the position of being helpful,” he went on, adding that he wants his team to continuously think of innovative ways to serve clients and stay relevant in today’s business world.

Wilcox doesn’t attend most meetings; he considers himself a leader but trusts his employees and wants them to become leaders themselves.

Account Manager Lisa Fox finds Team Concept beneficial, and enjoys the fact that account managers do all they can to help one another, which she finds significant, as she never received any help when she worked in the claims department of two large, multiline carriers before coming to Wilcox.

“We’re comfortable bouncing ideas off one another and asking each other for help; we all have our own strengths, and Team Concept has really given us a chance to see what has worked well and where we can do better,” she told BusinessWest, adding that sharing information is educational for everyone.

For example, a client recently wanted to get a homemade trailer registered. It was never a problem in the past; the Registry of Motor Vehicles had complied with similar requests after they saw store receipts listing parts purchased to create the trailer. But in this instance, the client used parts that he already owned, which included a chassis with a serial number that the Wilcox agent found had to be traced.

Fox said sharing information about how to handle similar requests in the future prove educational to everyone concerned. “The team approach really brings things to light and has benefittd the agency.”

Marylinda Kruzel agrees. “I have never worked for a place that had anything like the Team Concept,” said the commercial lines account manager. “It took time to structure our thinking and keep to the facts without judgment during meetings, but it has resulted in open communication throughout the month as we aim to provide unified service to clients. We strive to handle every scenario in a way that is best for the client.”

Mary Russell added that Team Concept has led the agents to trust each other’s knowledge and abilities. “We always focus on the positive and how we can help the client,” she noted, citing an instance where it was pointed out that the time a client spent at the agency might have been shorter if the application process had been completed during a phone interview.

Such changes can be accomplished in a matter of minutes, but Wilcox is happy with the outcome. “The team members are thinking on an entirely different level than they were when they were just doing the job in front of them,” he noted.

Legacy of Service

Wilcox describes his 26 years in the insurance industry as a “very rich experience” and is grateful for what he has learned from his customers, knowledge gained from acquiring other companies and during the building process, and the relationships he has formed on the job and in the community, as service has been a long-standing family tradition.

He was a member of the Rotary Club of Westfield from 1995 to 2009 and served several terms on its board of directors, and is treasurer for Sarah Gillette Services for the Elderly and a trustee to Noble Visiting Nurse and Hospice Services.

“All of this experience has led the company to where we are today; we are not here to sell people policies, but to share our experiences with others and be helpful,” he explained. “No one knows where a business will end up, but I believe independent insurance agencies will continue operating in the future, and I want to make sure I am one of them.”

Which seems likely as the team works with Wilcox to perpetuate a legacy that began almost 100 years ago when his great-grandfather set out to help others after suffering his own devastating loss.

“No one plans on having anything bad happen,”Wilcox said, “but if it does, we want to make sure they have the right coverage.”

Some Timely Advice on How to Get Back on Your Feet

By BusinessWest Staff October 18, 2016

Insurance Sections

Recovering from a Disaster

By John E. Dowd Jr.

John E. Dowd Jr.

Change in the business environment is expected. From regional landscape shifts and government regulations to emerging technologies, international competition, and more, it’s important to consider all the reasons why and how to insure your business.

And while some changes are predictable, others are not, but there are ways to plan for both.

What if you went to the office one morning to find nothing there? A flood, hurricane, tornado, or terrorist attack made it impossible to conduct business as usual. It’s not a purely academic question: thousands of business owners have confronted this very problem across the eastern seaboard in the wake of recent hurricanes, including Sandy, which devastated the New Jersey and New York shorelines with storm surges up to 20 feet high, and Matthew making headlines more recently. And it wasn’t hypothetical for New Orleans businesses in areas destroyed by the Katrina flooding, nor for dozens of businesses that had significant operations in the World Trade Center on Sept. 11, 2001. In the latter case, tragically, many businesses not only lost their offices, but people as well.

How would you get back on your feet? The odds, unfortunately, are against you.

According to research from the University of Texas, 43% of businesses affected by catastrophic disasters like 9/11, Sandy, and Katrina never open their doors again. Another 51% shut down within two years. Only 6% survive and go on to prosper.

The key, as with so many things, lies with preparation. Your chances of pulling your business out of a severe catastrophe are largely determined long before the catastrophe strikes.

Here are some of the types of insurance coverage business owners should consider to safeguard the future:

Liability Insurance: From medical or legal fees to damages a business may be held accountable for in the event of a disaster, liability insurance covers the day-to-day uncertainties of managing a business.

Workers’ Compensation Insurance: Employees who have sustained a work-related injury may be entitled to workers’ compensation. Not only is their contribution missed by your team, but the costs can be a burden if your business does not properly plan for their untimely absence.

Property Insurance: Did you skimp on flood or fire insurance? Do you store records in fireproof cabinets, or do you house them in a basement or low-lying, ground-floor storage that is prone to flooding? From weather-related disasters to fires and theft, property insurance is essential.

Life Insurance: Have you considered key-person insurance policies to have in place that could provide a cash cushion as your business deals with the death or disability of a partner or key employee? It’s important to consider the value that each staff member brings to your business and to have a plan in place if they were temporarily or permanently unavailable to continue work.

Cyber-liability Insurance: In the digital era, mother nature is not the only source of disasters. Most businesses handle some degree of sensitive customer information, and a data breach could be catastrophic. Cyber-liability insurance is essential to protect against a data breach and may help with legal defense, court-related costs, judgments, settlements, and costs involving crisis management, such as credit monitoring and public-relations services. Another type of cyber-liability insurance regards third-party defense and liability. This may produce liability coverage for electronic media, which could include copyright infringement, network security, and privacy liability issues.

An important note for small businesses is that they are frequently targeted for data breaches because they rarely have the resources such as a robust IT department to prepare and defend against cyber attacks. It is important to remember that general liability policies often exclude cyber liability and related costs. Any company that handles sensitive customer information must be aware of their vulnerability. If your company processes payments with credit cards, has access to customer bank-account numbers, Social Security numbers, or any medical data, you may be particularly at risk.

Have you gone through a formal process to determine your insurable risk in the event of a catastrophe? Generally, from the point of view of a business interruption insurance underwriter, your insurable risk is the amount of lost revenue due to the disaster, plus your monthly business overhead, times the number of months your business will be disrupted by a potential disaster. Whether your business is large or small, coverage choices can be complicated and intimidating. It makes sense to look to the experts in the field to make the process of examining your personal needs easier, and ultimately develop a plan that is customized and responsive to whatever may be in your future.

Finally, does your company have a formal overall disaster plan that would kick into gear after experiencing a serious catastrophic event? If not, your insurance agent/broker should be able to help you develop a plan that will make sure you are prepared for any situation that comes your way.

Taking the time to review this plan now before an event occurs makes very good business sense.

John E. Dowd Jr. is president and CEO of the Dowd Insurance Agencies, LLC. He represents the Dowd family’s fourth generation in the agencies, founded by his great-grandfather in 1898. Additionally, he holds several professional credentials and is an Accredited Advisor in Insurance (AAI) and a Licensed Insurance Advisor (LIA); (800) 542-0131; dowd.com

The Need for Cyber-liability Insurance Keeps Rising

By BusinessWest Staff February 23, 2016

Insurance Sections

Everyone’s a Target

HackInsurance

While major data breaches in the world of retail make the splashiest headlines — understandable, when, like the 2013 Target hack, they compromise the records of tens of millions of customers — the truth is, the vast majority of cybercrime incidents are aimed at businesses with fewer than 100 employees. That’s where cyber-liability insurance comes in — products that not only protect companies from the myriad financial effects of a breach, but help them understand where their risks may lie, and how they can close the more dangerous gaps.

Bill Grinnell said he recently spoke with the owner of a construction-related business who was hit with a malicious program that froze his company’s computers and followed up with an extortion demand.

“More hacks are happening every day,” said Grinnell, president of Webber & Grinnell Insurance in Northampton. “You wouldn’t think of him as the type of business that might traditionally need cyber-liability insurance, and now he’s facing all these costs — having a company come in to get the computers up and running, potential lost business income if they can’t perform their jobs without what’s stored on the computers, then the cost of the extortion and potentially notifying people, all the customer-relations issues.

“That was eye-opening to me,” he went on. “Any business out there that has any type of sensitive records critical to the running of the business potentially needs this type of coverage.”

The good news, Grinnell said, is that businesses are more aware than ever about the threats that lurk behind seemingly safe computer screens.

Bill Grinnell says cyber-liability insurance used to be a hot topic only in certain industries, like financial services, healthcare, and retail — but that’s changing.

“It’s a relatively new insurance coverage, and it’s still evolving. We certainly talk a fair amount about it with clients interested in purchasing coverage, and demand is definitely increasing,” he went on, noting that, until recently, cyber liability wasn’t a hot topic outside of the retail, medical, and financial-services industries, but it’s becoming clearer that many other types of enterprise are at risk.

In a recent article on its website, Ross Insurance Agency in Holyoke noted that incidents like the Target breach in 2013 (70 million customer records exposed) and the Neiman Marcus breach around the same time (1 million customers affected) won plenty of headlines, yet a 2012 Verizon study revealed that 71% of breaches occur in businesses with 100 or fewer employees. Meanwhile, according to cybersecurity company McAfee, almost 90% of small and medium-sized U.S. businesses don’t use any form of data protection.

“This is one of the most forefront issues we have, something we talk about all the time,” Kevin Ross, vice president of Ross Insurance, told BusinessWest. “Coverage is becoming more widely available and broader in scope. We have not experienced any losses here with our clients, but we do know it’s a serious threat that can cause serious financial harm. Just because you haven’t had a fire doesn’t mean fire insurance isn’t important. We protect the financial integrity of clients from loss, and those losses could be severe.”

Indeed, cybercrime costs American businesses more than $100 billion per year, according to the Center for Strategic and International Studies.

“Lack of an incident can breed complacency. Companies think they’re OK, but lack of an event doesn’t mean they’re OK; it doesn’t mean they’ve done a good job,” said Bill Trudeau, president of the Insurance Center of New England (ICNE) in Agawam, adding that, while certain organizations have more to lose because of their customer exposure, almost all companies save employee data digitally.

Bill Trudeau says hackers are always thinking up new ways to breach systems, and employers have to be prepared.

“Even in a small company, one that makes widgets and gets paid with checks, you could have some data-breach exposure with your employees, so it’s worth reviewing what kind of access you have,” he said. “If it happens to your 200 employees, it’s not going to be a heartwarming experience for you and your employees. You need to take a hard look at your computers and how you transmit information.”

Hefty Cost

According to the Ponemon Institute, which has been reporting on the cost of cybercrimes for the past several years, the cost to a company that falls victim to a data breach is $188 per record breached. Yet, business- and property-insurance policies typically exclude data risks from their terms, which has contributed to the emergence of cybersecurity insurance as a separate, standalone line of coverage.

That coverage typically protects against a wide range of losses that businesses may suffer directly or cause to others, and these come in two forms: first-party and third-party losses. Grinnell explained that third-party losses involve regulatory fines and lawsuits brought by affected customers, while first-party losses are what the business itself incurs up front, such as business-income loss, data-retrieval services, downtime, and notification of customers, to name a few. On average, first-party losses average about one-third of a breached company’s expenses.

“In a lot of small data breaches, say in a small store or a doctors’ office with 10 doctors, most costs are first-party costs,” Trudeau explained. “Then, later, you’re going to have liability claims because maybe someone did get injured, their identify got stolen, you may owe them compensation, or they could end up suing you, despite all your efforts. So a good cyber policy or data-breach policy has both coverage for first-party costs and a liability component that pays for these different injuries that have occurred.”

Some cybersecurity-insurance carriers pose a long series of questions on their application forms about the details of a company’s exposure to data risk, Trudeau said, and if the underwriter isn’t satisfied with the answers, they may not write the policy until certain practices have been changed and safeguards put in place.

Go HERE to download a PDF chart of the region’s Insurance Companies

“When it comes to a data breach which has occurred, a lot of what you do to take action up front can reduce your liability. If you self-report to authorities and if you have a turn-key response to it, that’s good,” he went on, noting that carriers that specialize in this type of coverage, like Beazley and Chubb, have turn-key response operations as part of the policy. “They’ve got forensic computer analysts that get into the system and see what went wrong, public-relations people who understand this issue — it’s not their first time trying to calm customers and the public as to what went wrong with your organization — and they also have third-party notification operations.”

Trudeau recommends that businesses hire a third party to poke around their computer systems and challenge their operations when necessary.

“People get used to their own surroundings and don’t know what they don’t know,” he said. “Just because you think your business isn’t super attractive to hackers doesn’t mean they’re not going to pick you. I think it’s important that people are always challenging their IT department or IT vendor, saying, ‘is this the best form of firewall?’

In fact, he added, ICNE works with a company that will provide an ethical hacker, which is someone not out to steal data, but to break into a system and then show the business what they found and how they got in.

“There has to be a discussion with the client about what they’re doing, how they’re identifying threats,” Ross added. “Everyone needs to be aware of it. Any time you’re dealing with any type of customer information, especially dealing with credit cards, Internet sales, anything that has to do with the web in any form or fashion, you could be exposed to liability should you be hacked and clients’ information be exposed. That’s the threat.”

Knowledge Is Power

The impact on businesses can be severe and long-term, the report noted, citing an Economist Intelligence Unit consumer survey conducted in 2013. It found that 18% of respondents had been a victim of a data breach, and, of those individuals, 38% said they no longer did business with the organization because of the breach. Meanwhile, 46% said they advised friends and family to be careful of sharing data with the breached company.

However, data breaches don’t always have malicious origins. According to the data breaches it serviced in 2013 and 2014, Beazley reported that the two most common sources of breaches are unintended disclosure, such as misdirected e-mails and faxes (31%), and the physical loss of paper records (24%), which is particularly prevalent among healthcare organizations.

Breaches due to malware or spyware represented only 11% of breaches in 2013 and 2014, but they have been increasing, the firm reported, with the total number of breaches in this category growing by 20% between 2013 and 2014. Due to heavy forensics costs — money spent to find out exactly how the breach occurred — these breaches are on average almost five times times more costly than unintended disclosure.

Still, considering the sheer number of cases of accidental data exposure, employers can take steps to prevent data theft, Ross noted. These include protecting every computer connected to the Internet or the internal network with anti-virus and anti-spyware software (including any laptops that connect wirelessly); installing security-software updates promptly to stay ahead of hackers; securing the company’s wi-fi network by requiring passwords or even configuring the wireless access point or router to hide the network name; securing computers and network components and requiring log-on passwords for all employees; and continually educating employees on security guidelines for computer, network, database, e-mail, and Internet usage, as well as penalties for violating those guidelines.

“The bad guys are always thinking up new things. It’s important to stay on top of it,” Trudeau added, noting that data breaches may not be doubling or tripling in frequency year over year, but they are rising slowly. The financial industry alone saw 642 incidents in 2014.

As a result, “the number of people willing to buy data-breach insurance continues to increase year after year, as more customers start seeing it as something that should be part of their insurance portfolio,” he went on. “You need to be vigilant of the fact that someone may have come up with some way to hurt your organization that you’re not aware of yet.”

Grinnell told BusinessWest that there’s still too many holes out there, due to nothing more complicated than complacency.

“A lot of people think it it’s big businesses getting hacked — ‘they won’t get me.’ I think that’s beginning to change, but there’s a long way to go,” he said. “We need to get the word out and let people know the exposures that lurk out there and help them address them, both through insurance means and making sure they have the proper firewalls in place to prevent attacks as much as possible.”

In other words, anyone can be a Target, and there’s ample evidence that some common-sense precautions — and perhaps a well-written insurance policy — can go a long way.

Joseph Bednar can be reached a [email protected]

Soaring Drug Prices Continue to Burden Consumers

By BusinessWest Staff February 23, 2016

Insurance Sections

No End in Sight

Maura McCaffrey says health plans work with drug companies to negotiate prices and with community physicians to assess patient needs, but rising costs continue to be a concern.

It’s a well-publicized issue in an election year, so it’s no surprise that lawmakers — including several presidential candidates — have been teeing off on soaring drug prices.

“Americans pay, by far, the highest prices for prescription drugs in the entire world,” Bernie Sanders recently noted. “A life-saving drug does no good if the people who need it cannot afford that drug.”

He pointed out that nearly one in five Americans between ages 19 and 64 did not get at least one prescription filled last year because they did not have enough money.

“There is no question that medicines help millions of people live healthier and longer lives, and can also prevent more expensive illnesses and treatments,” Sanders continued. “However, it is unacceptable that the United States now spends more than $370 billion on prescription drugs, and spending is rising faster than at any point in the last decade.”

Rising drug prices are having tangible effects on consumers, including those in Massachusetts. Among 16 carriers that recently testified before the state Division of Insurance, the first quarter of 2016 saw an average rate increase of 6.3%. They were asked to present the data used in determining their proposed rate filings for small-group plans in the second quarter of 2016. There are other reasons behind the increases, including the cost of expanding coverage under the Affordable Care Act, but drug prices are universally cited as a driving factor.

Meanwhile, even amid ever-louder complaints from lawmakers and the media, Pfizer, Amgen, Allergan, Horizon Pharma, and other manufacturers have raised U.S. prices for dozens of branded drugs since late December, with many of the increases between 9% and 10%, according to the Wall Street Journal. Overall, prescription-drug spending rose 12.2% in 2014, after just 2.4% growth in 2013, the Centers for Medicare and Medicaid Services reported.

What’s Happening?

There are a number of factors at play, ranging from the fact that the U.S. government doesn’t regulate drug prices to rising development and production costs; it can take more a decade and more than $1 billion to get a new drug approved. Still, there’s plenty of opportunity, industry critics say, to bring relief to patients.

“Their argument is we can — we can raise prices on this, the market will bear it, people like this drug, they rely on it, their physician will write it,” Marco Rubio recently told an audience on a campaign stop, blasting drug companies. “And so, because we can, we do. And it’s just pure profiteering.”

Insurance companies are feeling the pressure, Maura McCaffrey, president of Health New England (HNE), told BusinessWest. “Health plans have a responsibility to manage the pricing of these pharmaceuticals.”

They do this in two major ways, she explained. The first is to work with a pharmacy benefit manager, a third-party liaison between drug companies and insurers, to negotiate the drug prices. “Over the past year, Health New England did a very large renegotiation with its pharmacy contracts, and that has been very beneficial to members in Western Massachusetts.”

The second strategy is HNE’s clinical care assessment committee, which includes both primary-care and specialty physicians and meets eight times a year to discuss new medications — how they compare with current offerings and who the most appropriate patients would be.

“We come up with clinical criteria to make sure the right people have access to the right medications,” McCaffrey said, adding that, if the drug in question treats an uncommon condition, the committee will go into the local medical community to find additional specialists who can speak to that topic.

Difficult Spot

At the gathering before the Division of Insurance, Elin Gaynor, HNE’s assistant general counsel, cited several recent examples of unsustainable drug prices, including $259,000 per year for a drug treating cystic fibrosis, $118,200 per year for a breast-cancer medication, and more than $100,000 annually for a new hepatitis C treatment.

“As a community, we must be willing to tackle some very tough questions,” added Michael Caljouw, vice president of Government and Regulatory Affairs at Blue Cross Blue Shield of Massachusetts. “What is the right price for new drugs and therapies? What is the appropriate use of them? Who decides? How can we achieve a better balance between medical advances and affordability?”

In making coverage decisions, McCaffrey told BusinessWest, safety and effectiveness always trump cost. “Then, if it looks to be a safe and efficacious medication, we look at what else is on the market and compare the safety profiles and efficacy profiles. The last thing we do is compare the cost profiles. We do this every time.”

Dr. Peter Bach, a physician and director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, recently explained in the New York Times that drug manufacturers are hamstrung by the complexity of biology, government regulations, and shareholder expectations for high profit margins.

What they’re not saying, he went on, is that they take advantage of laws that force insurers to include virtually all expensive drugs in their policies, and an industry philosophy that demands that every new healthcare product be available to everyone — no matter its cost or how little it actually helps.

In late 2014, the New England Journal of Medicine detailed a number of ways drug companies take advantage of this system. For instance, they buy up the rights to inexpensive generic drugs, lock out competitors, and raise prices. In one example, albendazole, a drug used to treat certain kinds of parasitic infection, was approved 20 years ago and, as recently as 2010, had a wholesale cost of $5.92 per day. Three years later, it was $119.58.

“Many of these drugs remain key therapeutic tools. The number of prescriptions for albendazole has increased dramatically in part because the drug has increasingly been used to treat parasitic infections in refugees,” explained the report’s authors, Drs. Jonathan Alpern, William Stauffer, and Aaron Kesselheim.

“The Centers for Disease Control and Prevention recommends presumptive treatment of refugees arriving in the U.S. if they have not had prior treatment,” they went on. “Because the people who need albendazole are generally disadvantaged, the costs resulting from the enhanced demand and associated price increases are largely borne by the patients themselves through substantial out-of-pocket payments or by taxpayers through public insurers such as Medicaid and the Refugee Medical Assistance program.”

The albendazole situation is hardly unique, they added. “It is well-known that new, brand-name drugs are often expensive, but U.S. healthcare is also witnessing a lesser-known but growing and seemingly paradoxical phenomenon: certain older drugs, many of which are generic and not protected by patents or market exclusivity, are now also extremely expensive.”

For example, the price of captopril, which is used for hypertension and heart failure, increased by more than 2,800% between November 2012 and November 2013, from 1.4 cents to 39.9 cents per pill. Similarly, the price of clomipramine, an antidepressant also used for obsessive-compulsive disorder, increased from 22 cents to $8.32 per pill, and the price of doxycycline hyclate, a broad-spectrum antibiotic introduced in 1967, increased from 6.3 cents to $3.36 per pill.

The practice infuriated a number of U.S. lawmakers, who teed off on drug companies last month during a session of the Senate Special Committee on Aging.

“I find it so disturbing and unconscionable that a company would buy up a decades-old drug that it had no role in developing … and then would hike up the price to such egregious levels that it’s having an impact on patient care,” said U.S. Sen. Susan Collins, who chairs the committee.

Beyond the Status Quo

Solutions have been difficult to come by, but Bach suggests one: what if insurance companies weren’t required to cover all drugs? He explained that, in Europe, many countries reject a handful of drugs each year based on their high cost and relatively low effectiveness — so companies are forced to offer their products at attractice prices.

As a result, prices in Europe for prescription drugs are typically 50% below what U.S. consumers pay. The pharmaceutical industry might argue, he went on, that drug spending accounts for just 10% of all healthcare spending, but that equals around $300 billion per year — no small number.

And those costs are being passed on to patients. The Wall Street Journal noted that Lilly’s drug Cyramza will cost the average Medicare patient $2,600 per month without supplemental insurance — more than most Medicare-age people earn each month, before taxes.

It would make sense, Bach argued, to do one of two things: free insurers and government programs from the requirement to include all expensive drugs in their plans, or demand that policymakers set drug prices in the U.S. equal to those seen in Europe. “Either approach would be vastly superior to the situation we have today.”

The New England Journal of Medicine report offered another strategy for bringing prices under control. The authors suggest that substantial increases in the price of an unpatented drug could trigger the FDA to issue a public announcement seeking other manufacturers for generic versions of the product. Companies responding to such a request could receive expedited reviews of their manufacturing processes, and generic-drug user fees could be waived to further increase incentives for potential competitors.

Meanwhile, they concede, there is little that consumers can do.

“Some patients seek to acquire these drugs in other countries, since many of them are widely and inexpensively available outside the U.S., but such foreign sources may be of variable quality. Until regulatory and market solutions are implemented to reduce prices for these older drugs, patients requiring such drugs and the physicians treating them will continue to be faced with difficult choices.”

McCaffrey said Health New England is trying to maintain as much consumer choice as possible, but not at the expense of ballooning rates.

“Going into 2016, one of our top priorities is to make sure people have access to the medications they need,” she noted, “but at the same time make sure we can control premiums for them so they can afford the health insurance that gives them access to the medications they need.”

Joseph Bednar can be reached at [email protected]

Chase, Clarke, Stewart & Fontana Draws on a Rich History

By BusinessWest Staff November 2, 2015

Insurance Sections

A Downtown Institution

CCSF President Bob Stewart

Bob Stewart says that when it comes down to the fine print, there’s not a lot of difference in the cost of insurance policies from one company to the next.

“It’s all about relationships,” said the president of Chase, Clarke, Stewart & Fontana (CCSF), an independent insurance agency with deep, 144-year-old roots in Springfield. “Any insurance purchaser can go down the street and find another policy that may be a few dollars less than the policy they have. But it’s not all about being the lowest price on the street; it’s about providing the best coverage and providing the best service you can for your clients.”

He said his firm isn’t unique in that respect; in the era of managed competition, a time when large, national insurance chains have flooded the market with marketing campaigns focused on bottom-line promises, independent insurers have been forced to focus on the personal touch, or, as he called it, “servicing the heck out of it.” Fortunately, he added, that’s long been key to the culture at CCSF.

“That’s how we keep business — return the phone calls, answer the e-mails, go see clients,” he went on, noting that house and office calls make even more sense as downtown Springfield prepares for three years of construction hassles related to the MGM casino and the I-91 viaduct reconstruction.

“With what’s going on downtown, the parking is horrible, so we don’t encourage any of our clients to come into our office; we will go out and see them. We’re always hopping in the car; that’s just routine. We’d rather go see our clients in their office or home and talk to them there. That’s part of the service aspect, too.”

And those clients are diverse, Stewart said.

“We don’t necessarily specialize in any one thing; we do an awful lot of personal-lines insurance — homeowners, auto insurance — but we do a large amount of commercial insurance as well, a lot of professional liability, medical liability, social-service-agency liability, lawyers’ liability. I have a small program of accountants’ professional liability, with clients all over, from Boston to Pittsfield. My brother [Jim Stewart] runs a church program; he’s a broker for a national church organization, the United Church of Christ.”

Jim Stewart is one of three vice presidents, along with Dan Fontana and Raymond Lukas, and they all bring different types of expertise to the table, Bob explained. “We’re all over the map. Ray is a financial planner by trade, so he’s done a lot of life insurance, employee benefits, and financial planning, so any stuff we need done on that end, that’s always his bailiwick.

“It really is a fun business,” he went on, “and I wish we were able to attract more younger people into the field because it’s a great business. It might not have all the glitter of a Wall Street job, and we are in downtown Springfield, which doesn’t appeal to a lot of people. But it’s a wonderful business, and we’ve been very successful over the years. I’ve thoroughly enjoyed it.”

For this issue and its focus on insurance, BusinessWest sat down with Stewart to talk about why he’s a believer not only in his industry, but in Springfield itself, and why he’s still excited after 42 years in the business about helping people and businesses protect what’s important to them.

History Course

Since William Fuller opened an insurance business in downtown Springfield in 1871, that firm has never been headquartered more than a couple blocks from where it sits now, on the corner of State and Main streets.

“We’re probably the oldest independent agency in Springfield — maybe in Western Massachusetts,” Stewart noted. “Basically, our history is a series of mergers and purchases over the years.”

Fuller’s agency was later acquired by Samuel Sherwood and William Cone, growing under their leadership and then with Sherwood’s son, Malcolm. Raymond Redfield then added the business to his own agency, along with the Oppenheimer Agency, which had started around 1880. In 1957, Redfield invited the Russell D. Chase Agency and the Arthur H. Clarke Agency to merge together as Redfield, Chase & Clarke.

Meanwhile, another agency had been thriving in Springfield — the Lewis J. Stewart Insurance Agency, started by Stewart’s grandfather just after World War I and later run by his son, Robert Stewart Sr. In 1966, that agency joined with the growing Chase agency, which was renamed Chase, Clarke, Stewart. Bob Stewart came on board in 1973, followed by Jim in 1980.

Click HERE for a listing of area insurance companies

But the consolidation process was far from over. In 1995, the agency merged with the R.J. Fontana Agency — bringing Dan Fontana into the fold — forming Chase, Clarke, Stewart & Fontana.

CCSF, located in the office building on the corner of State and Main Streets, has had a presence in downtown Springfield for nearly 150 years.

In 2000, the company purchased the Mutual Insurance Agency of Springfield, whose history dates back to 1827. Finally, in 2004, CCSF purchased the Lukas Insurance Agency of Springfield.

Through it all, the commercial-lines business has changed little over the years, save for occasional shifts in rates, but the same can’t be said of personal lines.

“That has changed drastically since what they call managed competition,” Stewart said. “Take auto insurance — back in the ’80s, we had probably about 12 insurance carriers writing auto insurance in Massachusetts, and not the big ones. No one wanted to come in because the state set the rates and said, ‘this is what you’re going to charge.’ Insurance companies were bound by those rules, and most of them felt they couldn’t make money in Massachusetts.

“But then the gloves came off and managed competition started,” he went on. “Insurance companies could set their own rates within certain parameters, so the field is much more wide open now. We’re now competing with the big insurance carriers from all across the country.”

Before this new era, he explained, independent agents wrote some 80% of auto policies, which was unheard of across the U.S.; that figure was closer to 40% or 50% in most states.

“That market share has dropped, and we knew it was going to,” Stewart went on. “And it has caused the insurance carriers we do business with, the independent-agency carriers, to really come up with some unique and unusual coverages and pricing to compete with some of the big companies that have come into the state. They’ve been very responsive. They’ve stepped up to the plate when they needed to compete from a pricing standpoint or from a coverage standpoint, by enhancing policies.”

Marketing has changed in some ways as well, particularly with the emergence of social media, which CCSF has put to effective use with a blog, where it shares information with various types of clients — for example, an article about cybersecurity for business customers, about insulation for homeowners, and about child car safety for motorists, just to name a few recent entries.

“That’s one way to stay in touch with them, let them know what’s going on in the industry, what kinds of things they can do to lower their premiums, protect their properties, and lower their risk,” he explained. “We’re been fortunate to have a young woman in the office who is really versed in social media. I’m kind of old-school, but everyone says it’s beneficial, so we’ll continue to do it.”

Selling a Promise

Stewart is just as pleased to see the changes emerging in Springfield — not just the casino, but a surge of activity and new business in the central business district that give him hope for the city’s future.

“When I started here in 1973, it was an entirely different downtown area. We had Steiger’s, Forbes, A.O. White, Johnson’s Bookstore — all sorts of stuff down here,” he told BusinessWest. “We went from that to seeing not much of anything in downtown Springfield. But I’m positive about the changes that are proposed and are happening. I they will benefit the city as a whole, not just downtown. I’m very positive about it. For those of us who work right in the center, what’s going on now in construction is inconvenient, but it’s an inconvenience that will be short-lived.”

Three years of construction and traffic snarls may not seem short-lived to some business owners, but with his company’s history sprawling back 144 years, he finds it easy to take the long view. Besides, there’s always someone new to get in the car and visit.

“For me, it’s really all about the people I deal with. We have a tremendous staff in our office, it’s fun to deal with them, and it’s fun to deal with all my clients — I really enjoy talking to people, going out to see them. That’s what makes it interesting. If I had to sit behind my desk all day, every day, I’d probably be miserable.”

Stewart is also gratified by a job where he helps people protect themselves against the worst, or at least mitigate hardships when they do strike.

“One client I’m dealing with now, his house was badly burned — a very extensive, very serious loss,” he said. “I talked to them a few times the last few weeks, and things are going smoothly, and the checks are getting cut. It’s good to see that what we’ve provided for them is actually going the way it’s supposed to, and things are being put back together without any further issues.”

At its heart, he concluded, “all we’re selling as an insurance agency is a promise, so we’d better be able to deliver on that promise when the time comes.”

Joseph Bednar can be reached at [email protected]

Six FAQs About EMV Credit Cards and Crime Coverage

By BusinessWest Staff November 2, 2015

Insurance Sections

Take Charge of the Situation

By DAVID GRIFFIN

David Griffin

The nationwide shift to EMV is well underway.

EMV — which stands for Europay, MasterCard and Visa — is a global standard for cards equipped with computer chips and the technology used to authenticate chip-card transactions. In the wake of numerous large-scale data breaches and increasing rates of counterfeit card fraud, U.S. card issuers are migrating to this new technology to protect consumers and reduce the costs of fraud.

“These new and improved cards are being deployed to improve payment security, making it more difficult for fraudsters to successfully counterfeit cards,” says Julie Conroy, research director for retail banking at Aite Group, a financial industry research company. “It’s an important step forward.”

Most of all, it means greater protection against fraud.

Approximately 120 million Americans have already received an EMV credit card and that number is projected to reach nearly 600 million by the end of 2015, according to Smart Card Alliance estimates.

Here are six frequently asked questions to help you understand the changes:

1. Why are EMV cards more secure than traditional cards?

It’s that small, metallic square you’ll see on new cards. That’s a computer chip, and it’s what sets apart the new generation of cards.

2. How do I use an EMV card to make a purchase?

Just like magnetic-stripe cards, EMV cards are processed for payment in two steps: card reading and transaction verification.

3. Will I still have to sign or enter a PIN for my card transaction?

Yes and no. You will have to do one of those verification methods, but it depends on the verification method tied to your EMV card, not if your card is debit or credit.

Chip-and-PIN cards operate just like the checking-account debit card you have been using for years.

4. If fraud occurs after EMV cards are issued, who will be liable for the costs?

Today, if an in-store transaction is conducted using a counterfeit, stolen, or otherwise compromised card, consumer losses from that transaction fall back on the payment processor or issuing bank, depending on the card’s terms and conditions.

After an October 1, 2015, deadline created by major U.S. credit card issuers MasterCard, Visa, Discover, and American Express, the liability for card-present fraud will shift to whichever party is the least EMV-compliant in a fraudulent transaction.

Consider the example of a financial institution that issues a chip card used at a merchant that has not changed its system to accept chip technology. This allows a counterfeit card to be successfully used.

“The cost of the fraud will fall back on the merchant,” says Martin Ferenczi, president of Oberthur Technologies, the leading global EMV product and service provider.

EMV Cards and Retailer Liability

Most insurance carriers have a coverage called either “data breach” or “cyber liability.” Presently the coverage has been undersold. With the conversion to EMV cards, it is very important for retail merchants using credit cards to become familiar with this coverage and its options. Coverage varies by carrier coverage forms. The important thing to know is that local businesses have a larger exposure.

In addition, EMV debit cards will roll out at a slower pace; only 25% of debit cards will utilize EMV by the end of 2015. This number will increase to 96% by the end of 2017. Automated fuel dispensers will have until 2017 to shift to EMV cards.

5. If I want to use my chip-card at a retailer that doesn’t support EMV technology yet, will it work?

Yes. The first round of EMV cards — many of which are already in consumers’ hands — will be equipped with both chip and magnetic-stripe functions so consumer spending is not disrupted and merchants can adjust.

If you find yourself at a point-of-sale terminal and are not sure whether to dip or swipe your card, have no fear. The terminal will walk you through the process.

“For example, if you enter a card into the chip reader slot but the reader isn’t activated yet, it will come up with an error and you’ll be prompted to swipe the card in order to use it,” says Randy Vanderhoof, executive director of the Smart Card Alliance.

And vice-versa.

6. Will I be able to use my EMV card when I travel outside the country?

Yes and no.

The U.S. is the last major market still using the magnetic-stripe card system. Many European countries moved to EMV technology years ago to combat high fraud rates. That shift has left many U.S. consumers who have magnetic-strip cards looking for other forms of payment when they travel.

Finally, as criminals become more and more sophisticated, it is important to make sure, as a business, your crime coverage does as well. Do you have cyber liability coverage, electronic fund transfer fraud coverage, and employee dishonesty coverage?

Crime coverage in the future will be as important to buy as general liability coverage.

David Griffin is a principal and the executive vice president and treasurer of The Dowd Insurance Agencies. He is a licensed insurance advisor (LIA) as well as a certified insurance counselor (CIC); [email protected]; (413) 437-1005.

Hitting the Links

By BusinessWest Staff June 2, 2015

Insurance Sections

Insurance Agencies Raise Their Profile Through Blogs, Social Media

In an industry as competitive as insurance, Maureen Ross O’Connell succinctly stated what must be the goal for every agency: “we want people to think of us when they think of insurance.”

Bill Grinnell says social media is limited in how much business it can attract, but it’s still important to maintain an online presence.

But in an era when Americans, especially the younger crowd, aren’t reading as much print media as they used to — the striking decline of daily newspaper readership over the past two decades testifies to that trend — how do agencies reach out to potential new customers?

One answer is social media, from Facebook pages to LinkedIn listings to blog posts, said Ross O’Connell, president of Ross Insurance in Holyoke. But the messages and techniques used on these media are strikingly different than what might be considered traditional marketing.

“We don’t talk much about insurance on Facebook at all,” she said of the company’s lively Facebook page, which is updated virtually every day. In the weeks before this article went to press, Ross posted an article about a major airbag recall, but also one about how parents feel when their kids start driving and another about identify theft.

Meanwhile, the agency shared congratulations to the region’s high-school and college graduates, recognized National EMS Week, shared information on the Great New England Air Show, polled readers on favorite cookout foods, and solicited comments on Deflategate. In short, the page mixes helpful information — only occasionally touching on insurance-related topics — with a healthy dose of fun and human interest.

“People are not on social media to be sold to; they get annoyed when you try to sell to them on Facebook,” Ross O’Connell said. “We run contests, share relevant information, but we’re not trying to sell insurance on Facebook. They have an opportunity, if they’re so inclined, to request a quote off the Facebook page, but mostly, we just want to be part of the conversation.”

Meanwhile, Agawam-based Insurance Center of New England (ICNE) maintains its Facebook page with several posts per week. Recent topics range from auto safety and roadside emergencies to photos from the company’s recent Paint Craze Night to benefit the YWCA; from congratulations to clients that have won awards to an infographic about financial literacy in childhood. Meanwhile, several articles posted to the ICNE’s website delve into weightier insurance topics, from Affordable Care Act compliance to workers’ compensation.

“We definitely are embracing the tools — not to say we’ve mastered them,” said company President Bill Trudeau, noting that ICNE also engages with the region’s professional crowd through LinkedIn. “Our Facebook persona tends to be more community-oriented. We do put some things about insurance in there if it’s something of interest, like the windshield-wiper thing, using headlights when they’re in use. Or we might say something about fire-safety reminders. But it’s not filled with insurance stuff.”

The goal in posting any item on Facebook, he continued, is for people to read it and find it interesting — and hopefully keep coming back. Meanwhile, sharing news about local events and causes ICNE or its employees are involved in drives home their connection to the community. “We see it as a way to demonstrate what we’re all about, Trudeau said, “what we’re up to besides insurance.”

Bill Grinnell, president of Webber & Grinnell Insurance in Northampton, said his firm has focused increasingly on social media and online communications over the past two years, but the jury is out on what the agency gains from such activity.

“I am still unconvinced how we benefit,” he told BusinessWest. “We’re certainly doing it, but I don’t think it’s a silver bullet that will propel my business forward by any means.

“People just don’t go to insurance-company websites to hang out,” he added. “When we post something on Facebook, we want to make it interesting — but it’s not the most exciting business in the world. Obviously, we try to get people to follow us on social media, but that doesn’t replace old-fashioned ways of getting new business. Still, I do feel we are ahead of the pack in terms of our social media.”

Home and Oughta

Most effective, Grinnell said, is the company’s two online newsletters — the Guardian, geared to personal-line (home and auto) customers, and the Protector, which goes out to business clients, business prospects, underwriters, vendors, and other people the agency associates with. The contents of those newsletters then get posted to Facebook and LinkedIn.

“We do keep it somewhat relevant,” Grinnell said. “For example, in our personal-lines newsletter, we had an article over the winter with a lot of great information about ice dams — what causes them and how to prevent them. We also had a nice article on how your insurance company responds to water damage. We followed that up with what’s covered in flood coverage, seepage, and so on. That got good response from people.”

He’s currently drafting an article on how points affect auto-insurance premiums, and another on the pros and cons of different deductible levels and what kind of savings customers should expect. Meanwhile, the business-insurance newsletter recently featured a piece on workplace injuries and the impact they have on business income, business interruption, and insurance coverage.

“I went recently to an Employers Association meeting about employee engagement and got a couple of jewels from that on helping me run my business,” Grinnell went on. “Then I put an article in my newsletter; I took what I learned from it and shared it with my customers.”

Similarly, Ross O’Connell said the blog on her agency’s website — updated regularly by a full-time social-media architect, and featuring articles on everything from employee benefits to motorcycle safety to health-insurance plan options — is also geared to customers as well as prospects.

That architect, Krystal Carvalho, also writes for a second Ross blog, insurance-boss.com, which mixes hard information with lighter fare, like a piece on Easter desserts, and profiles of agency clients. But there is some crossover among the two blogs and the Facebook page.

“Everything changes in the social-media world,” Ross O’Connell said, “so much so that we’re shifting our philosophy and bringing our soft social stuff onto our website as well. So charity work, community events, that used to be all on insurance-boss.com, but the ultimate goal here is to drive people to our website. So our strategy is shifting a little bit now as we speak.”

To varying degrees, all the agencies that spoke with BusinessWest said social media can be a branding tool to keep a company’s name and community connections on people’s minds. Trudeau said this happens when ICNE posts a photo of a newly hired employee.

“We might stay more top of mind the next day,” he said. “And if someone asks them, ‘I don’t have a good agency; who do you use?’ hopefully they’ll think of us just a tiny bit more than if they had not seen anything.”

Social media has other practical uses, Grinnell added, noting that LinkedIn can be a solid recruiting tool. “We can communicate with all our LinkedIn friends about positions that are open and also look at individuals who might fit the job description. That has been useful to us.”

Brand Names

Trudeau said businesses that post regularly on social media have to strike a balance between being interesting and annoying; no one wants their feed clogged with material they have no use for.

Still, Ross O’Connell said, “it’s absolutely important to have a presence on social media — we have to be part of the conversation, branding ourselves.”

She added that the agency’s initial goal when starting to delve into social media was to reach out to the younger generation. “Of course, the average age on Facebook is now 55, but that was not the case when we started. We’re reaching a diverse audience.”

Trudeau also sees value in being part of the daily conversation on people’s news feeds.

“People have a lot of choices in the marketplace, where they can buy house and car insurance. If they see they can get competitive prices from someone who’s engaged in their community, we think people will choose to work with us as opposed to what we call a black box: ‘OK, time to get on the computer for a quote from State Farm, Geico, Progressive, or Allstate.’ You’re not going to run into those people at the local Red Cross board meeting; they don’t really have a specific presence in the Pioneer Valley.”

In short, the company’s pitch is that it represents many different carriers and can offer attractive products, he added. “But social media gets out the message that we’re engaged in the community, and here are some things we think are interesting and fun about us.”

Grinnell said there’s an element of client retention as well, and making sure customers are engaged with the agency and even expanding the relationship.

“It’s a very competitive world in the insurance business these days, and the insurance companies do most of the billing, most of the processing, so typically people don’t hear much from their agent unless they have reason to call them,” he told BusinessWest. “We felt it was important to get out in front of them and remind them who we are. We bring value to the table, and we try to bring value in that newsletters.”

As Ross O’Connell mentioned, however, the landscape is always shifting, so insurance agencies are constantly challenged to change with the times.

“We don’t always have all the time we need to do it,” Trudeau said. “It took a while to build those muscles, to have everyone remember, ‘hey, if you’re going to be at such-and-such event, get us some material.’

“We’re all students of social media,” he added, “and we’re doing what we can to do it better.”

Joseph Bednar can be reached at [email protected]

Lines of Defense

By BusinessWest Staff June 2, 2015

Insurance Sections

Insurance Is Personal — and Business, Too — at Moulton

By CLARK HOWELL

It has been exactly four years since tornadoes struck Western Mass. on June 1, 2011, an event that insurance agents remember well.

Cindy Moulton St. George (center), daughter Katie Gagner, and husband Roy St. George represent the second and third generations of this family business.

Cynthia Moulton St. George, president of Moulton Insurance, recalls her employees climbing through downed trees and over debris to get to clients in the days following that unexpected disaster, which resulted in some $150 million in damages.

“We had gotten authority from our companies,” Moulton St. George said, “and they would refund our accounts. And we would just go and write checks … because people had nothing.”

She added that some people victimized by the twisters had everything “sucked right out of their house — if their house was even there.”

Katie Gagner, who manages the company’s Belchertown office — Moulton has additional offices in Palmer and Ware — added that “it was crazy” in those hectic first days of writing checks and consoling clients and residents after the disaster.

As a third-generation family business launched by Moulton St. George’s father in 1952 (Vice President Roy St. George is her husband, and Gagner is their daughter), they say they understand the needs of both families and businesses — a commitment put to the test by the tornadoes, but one in play every day.

“We are an advocate for our clients,” Moulton St. George said, adding that the image of agents sitting behind a desk is inaccurate, and that getting out into the community — though usually not scrambling over tree branches — is every bit as important as doing the paperwork of a claim.

Moulton St. George said it’s that personal connection to the community that sets independent agents apart from the large, national direct sellers of insurance.

For example, she went on, many auto service centers, and especially auto-body repair shops, won’t even do business with motorists who have direct-seller auto insurance. “They have signs right in the shops, many of them, that say, ‘if you have XYZ Insurance, don’t bother asking us to do your repairs.’”

Independent agencies like Moulton are different for many reasons, she said, but especially because they actively advocate for clients, particularly “when it comes to the claim, which is why you buy insurance.”

Setting Their Sites

When she and St. George sat down with BusinessWest, the company was both celebrating some recent successes and taking steps to further raise its profile.

Specifically, the agency had just received the Long Term Service Award from the Quaboag Hills Chamber of Commerce, and was preparing to launch a new, content-rich website.

The website — which will offer more information on business and commercial lines of insurance — is important, Moulton St. George said, because people don’t always associate the company with those areas of expertise, even after 63 years in business.

“Businesses may not look at Moulton Insurance as the go-to agency for commercial lines,” St. George said, but added that perceptions will change once people become aware of the extensive list of business and commercial products offered by their company.

However, he explained, auto, home, and life insurance will continue to play a vital role in the overall mix of products Moulton offers to residents of Massachusetts, Connecticut, New Hampshire, and Vermont.

A stronger web presence is important for an agency based in the Quaboag region that aims to reach across Western Mass. and beyond. St. George said the company probably could have better advertised its experience with commercial lines in the past, which is one reason the website is getting an overhaul.

“We can handle anything from a Main Street type business to a manufacturing facility,” as well as the fleet of vehicles associated with that company, he said, adding that Moulton represents more than 15 insurance carriers, both regional and national, to provide options should a situation require specialization.

St. George is equally proud of the employees representing those products. He noted that many agencies in Western Mass. have relatively low ratios of full-time licensed agents to total employees. In other words, an agency might have three licensed agents and a total number of 14 employees, meaning that the majority of employees can only handle administrative work, and not the actual work of determining the best insurance product for a given situation.

Of Moulton’s 16 employees, however, 14 are licensed agents, ranking in the top 20% of agencies in the region by ratio of agents to employees. Further, the agency boasts five certified insurance counselors (CICs), three in the commercial area alone.

The CIC designation, he explained, is a mark of distinction that represents a commitment to professional excellence and leadership within the industry. CICs are recognized as among the best and most knowledgeable insurance practitioners in the nation. The designation is earned by attending five intensive CIC Institutes: agency management, commercial casualty, commercial property, life and health, and personal lines. The formal training required to become a CIC includes 100 classroom hours and the successful completion of comprehensive exams in these five areas of expertise.

Moulton also boasts eight certified insurance service representatives (CISRs). These agents have gone through a program that offers additional learning opportunities in the commercial-lines and personal-lines arenas, as well as courses in health and risk management.

Earning Trust

However, St. George and Moulton St. George both stressed, knowledge of insurance products alone won’t make an agency a trusted entity within its region. That comes from years of dedication and service to a community.

“Our reputation is a big part of what we do,” Moulton St. George said, noting that her father, Charles Moulton, had the foresight in 1952 to start an insurance agency that strived to bring personal service and cost-effective insurance coverage to area customers. Since then, she said, the company’s agents have made deep connections to the community.

The new website, they say, is just one way of raising the agency’s profile and letting insurance shoppers know what Moulton can offer to protect against the storms of life and business. Sometimes literally.

Serve and Protect

By BusinessWest Staff June 2, 2015

Insurance Sections

A chart of the region’s insurance agencies

Click HERE to download the PDF chart

Danger from Above

By BusinessWest Staff February 24, 2015

Insurance Sections

Insurance Companies Enlist Help from Homeowners to Prevent Losses

When recalling the bizarre weather that descended on Western Mass. in 2011 — tornadoes in June, midsummer flooding, the freak pre-Halloween snowstorm — it’s easy to forget that, even absent all of that, the year would have been a challenging one for home insurers.

The reason? A January and February riddled with ice dams and roof collapses, thanks to snow that seemed to fall every other day for weeks on end, gradually building up the weight on houses and damming under the eaves, causing water to pour into homes.

“We paid a lot of claims. That was a big deal,” said Kevin Ross, vice president of Ross Insurance in Holyoke. But while the past few weeks have brought a similar onslaught of snowstorms, he doesn’t expect nearly as many claims this year.

“A lot of people are absolutely more attuned to this; everywhere I go, people are talking about getting a roof rake and cleaning off their roof,” he told BusinessWest. “People are well aware of ice dams and the problems they can cause. I just contacted a roofer to clean off my roof because ice is starting to build up in the gutter. In general, the population understands what can happen, and everyone is cleaning off the roof now.”

It’s a learned behavior being observed across the industry.

“We’ve had a couple of claims come in,” said Corey Murphy, president of First American Insurance in Chicopee. “Fortunately, it’s not as bad as it has been in the past, even with some of these strong storms we’ve had.”

John DiStefano of Preferred Mutual Insurance agreed.

“As I drive around, I see homes where people have used roof rakes to get some snow off around the edges, or they have people going up on the roof shoveling for them. That’s always a proactive approach,” said the personal-lines territory manager for Massachusetts and New Hampshire.

That’s good news for both homeowners and insurers, he said, considering that such events are covered by most basic plans. “Roof collapses and water damage, where water seeps into the home, is covered under most forms. That is a pretty common thing.”

Therefore, it’s good news for insurance companies — which implemented rate increases of 5% to 15% regionally after the 2011’s series of unfortunate events — that customers are increasingly taking matters into their own hands by keeping their roofs and gutters as clear of snow as possible.

But when it comes to winter home hazards, they say, roofs are only part of the picture.

Peak Problems

Typically, Ross said, homeowners facing winter roof damage don’t have to scramble to see if they’re covered.

“The standard policy doesn’t have to change to provide coverage of interior or exterior dmage caused by an ice dam, or even the collapse of a building,” he noted. “However, there are certain exclusions for the collapse of a fence, a patio, a swimming pool — those are not covered. Collapse of foundations or retaining walls, bulkheads, are not covered.”

Kevin Ross says homeowners have become more proactive about preventing roof damage during the winter, and insurance companies have become better at educating them.

But once an ice dam is reported, “right away, the insurance company will pay a reasonable amount to remove ice and snow from the roof to prevent further damage,” he explained. “But only once the damage has begun — we’re not going out to clean off everyone’s roof.”

The immediate drama of an ice dam, pouring water into interior spaces, can panic policyholders, Ross added. “They’re wondering, ‘what should I do?’ Call the insurance agent right away; they will only take one deductible until all the snow is gone from roof.”

That could encompass the entire winter, he noted. “Don’t be afraid that a week later you might have more water coming in. It’s considered one event until all the snow is off the roof. So, once it starts, once you notice water inside the house, call your agent right away.”

As for roof-collapse concerns, that’s a tricky area to navigate, because the weight of the snow isn’t always clear from a visual check, forensic meteorologist Steve Wistar noted at accuweather.com.

In the Northeast, he explained, roofs are generally designed to support 30 pounds per square foot, but some are built to support 40, 50, or even 100 pounds per square foot. Further complicating matters, that weight is determined by water content, not merely depth.

Specifically, dry, powdery snow weighs less than wetter snow, and its flaky texture makes it prone to drifting, which is ideal for roofs designed to handle drifting snow. But, over time, snow compacts and settles down, meaning the snow won’t be as deep, but the weight will be the same, Wistar said.

Finally, when temperatures rise and snow becomes rain, the snow already coating rooftops can become saturated with moisture, weighing it down. And even when the snow does begin to melt, it can refreeze around gutters and drains, trapping more melting water on the edges of the roof — which, of course, can cause ice dams.

Columbia Gas of Massachusetts recently issued yet another concern for homeowners regarding rooftop snow accumulation — specifically, a number of incidents involving large icicles and snow accumulation falling from rooftops onto natural-gas meters, causing gas-line ruptures and gas leaks.

The company noted that it’s important that natural-gas meters and exhaust vents for heating equipment and other appliances are free of snow and ice, as gas equipment requires adequate airflow for safe combustion — and proper venting of appliances — to prevent dangerous carbon-monoxide situations.

Recent winters in Massachusetts have seen brisk sales of roof rakes as homeowners try to prevent ice dams from forming.

Columbia Gas president Steve Bryant encouraged homeowners to use a broom — not a shovel — to clear ice and snow from gas meters, and to avoid kicking or hitting the gas meter to break away snow and ice. “Don’t shovel snow up against your meter. Be careful when using a snow blower or snow plow near your meter. Where possible, have a clear path to your gas meter in the event a technician or emergency responder should require access.”

Cold Snap

When protecting their homes from cold-related damage, Ross said, customers shouldn’t look outside only.

“Losses can occur if you don’t keep adequate heat inside the home,” he noted. “Sometimes, when you leave for a week in Florida, you figure, ‘I’ll just turn my thermostat down and save on energy costs,’ and you come back to find that a pipe froze and burst. That’s something else from a loss-control standpoint. You need to keep adequate heat in home to keep things from freezing. It’s important to maintain the heat at 60, 62 degrees so they don’t have that problem.”

DiStefano agreed. “Do everything you can to maintain temperature,” he told BusinessWest. “Also, if you’re going away, shut off the water. That way, if a pipe breaks, it’s not a major problem. It’s easy to do, but so many people don’t do that.”

Because home insurance covers personal liability in addition to property damage, he also encourages customers to keep sufficient ice melt handy to prevent slips and falls by the mailman, UPS driver, or neighbors.

“The policy does provide personal liability coverage for slip-and-fall types of claims,” Ross added. “The owner of the property has a responsibility to keep their walkways and driveways, safe for pedestrian traffic. That’s definitely another area people really need to be cognizant of right now.”

It’s not like winter necessarily poses more weather-related insurance hazards than the rest of the year; damage from warmer-weather events, like tornadoes and hurricanes, are typically covered, Ross said, although policyholders might want to check on whether they’re in a covered flood zone and, if not, whether they’d like to add that to their plan as well.

But cold-weather threats are typically slower-developing, DiStefano said, giving insurance clients a chance to prevent them with tools as simple as roof rakes and sidewalk salt.

“More and more companies, like Preferred Mutual, have our websites set up with information for the general public to look at,” he said, “and we talk about what to do during the winter months to prevent losses.”

That pleases Ross, who clearly recalls the surge of claims in early 2011, when roof collapses and ice dams caught too many Western Mass. residents off guard.

“It was huge,” he said. “But it’s not going to be quite the same this year from a claim perspective, because people are more proactive; they’ve learned from it. A lot of people are raking the snow off already, getting the snow out of the gutter before the next storm. You have to stay on top of it. It’s a big maintenance issue.”

And one with no end in sight, Bryant added. “With record snowfall over the past month,” he said, “this winter season continues to be a challenge for us all.”

Joseph Bednar can be reached at [email protected]

Cost Control

By BusinessWest Staff February 24, 2015

Insurance Sections

High-deductible Health Plans Find Fertile Soil

Jody Gross says the percentage of insurance consumers using high-deductible plans is still small, but growing quickly.

Pay now or pay later?

Employers and consumers shopping for health insurance have to ask themselves a version of this question when considering the option known as high-deductible health plans (HDHPs), which offer lower premiums than traditional plans but much higher deductibles, or the expenses that must be paid out of pocket before the plan begins footing the bills.

HDHPs typically feature deductibles exceeding $1,200 for individuals or $2,400 for families — often by a lot. In fact, according to the 2014 Employer Benefits Survey conducted by the Kaiser Family Foundation Health Research & Educational Trust, the average deductible for individual coverage paired with a health savings account is $2,098, but 18% of workers have a deductible of $3,000 or more. For family coverage, deductibles average $4,059, with almost one-third topping $5,000.

“This makes for a potentially dramatic shift in patient behavior and thinking,” Leah Binder, president and CEO of the Leapfrog Group, wrote in Harvard Business Review. “In traditional plans, even if you have a deductible, you skim to the section of the bill that says ‘patient responsibility.’ It’s usually a nice, round co-pay like $25 or $50 — the same, predictable amount regardless of which services you received. In contrast, with an HDHP, the whole bill is yours to pay.”

Although HDHPs are not a new idea, Binder explained, they’ve received a jolt of life over the past decade, with George W. Bush’s administration pushing for employers to offer the option, and the Democratic-led Affordable Care Act greatly accelerating the adoption of such plans, as the new state insurance exchanges usually feature high-deductible options.

“The IRS has set up some specific qualifications for what constitutes a qualified high-deductible health plan,” said Jody Gross, vice president of Sales at Health New England. “We have a $2,000 high-deductible health plan for an individual, $4,000 for a family, and the premiums are typically much more affordable.

“In order for it to be a qualified plan,” he added, “by definition, all services need to go toward that deductible, whether it’s an inpatient stay, an office visit, prescription drugs … all services need to go toward that deductible. The exception is preventive services — your annual physical, a mammogram, things like that; the government has a list of items that don’t need to go toward that deductible. Even so, a person pays a lot out of pocket before the plan kicks in.”

Accompanying many HDHPs is a product called a health savings account (HSA), by which a plan enrollee — and, in some cases, his or her employer — contributes money tax-free to an account that can be used to pay healthcare expenses. Any unused balance at the end of the year is not lost, but rolls over into the next year.

High-deductible plans and health savings accounts go hand in hand and are often an effective way for consumers to take more control over their care by forcing them to weigh the actual cost of each treatment, visit, or medication, Gross said. “Health insurance — and healthcare in general — is expensive, so the federal government set these plans up, these health savings accounts, in order to drive people down that continuum of healthcare products.”

Meredith Wise, president of the Employers Assoc. of the NorthEast, said many employers are moving toward HSAs and high-deductible health plans.

“A lot of it is because of the rising premiums,” she noted. “As you look at the deductibles and the maximum out-of-pocket expenses of most plans these days, you’re just about at that high-deductible threshold, so going to high-deductible health plans is an easy move for companies to make.”

Seeking Savings

The national numbers bear out that trend. According to the Kaiser survey, one in five workers had an HDHP in 2013, up from nearly zero in 2006. Meanwhile, half of all firms with more than 5,000 workers now offer HDHPs.

“High-deductible plans are attractive to employers because they get to bear less of the insurance cost. Many economists also like the plans, because they’re supposed to make people spend more wisely on their healthcare,” noted Jason Millman in the Washington Post.

“The big question is whether employees are prepared to handle potentially big medical bills before they hit their deductible,” he continued, noting that enrollees in employer insurance typically say they’re happy with the services their health plans cover, “but they’re much less satisfied with what they’re paying out of their own pockets.”

That caution seems to be more prevalent in Massachusetts, Gross said.

“At Health New England, 5% to 6% of our membership is on high-deductible health plans,” he told BusinessWest. “In Western Mass., they haven’t taken off like wildfire. They may shortly, but they haven’t yet, because so many services go toward the deductible, and people aren’t willing to pay a lot less in monthly premiums to have all their prescription drugs and everything else go toward that deductible.”

Wise noted that Massachusetts was initially slow to approve HDHPs. “I think, when high-deductible health plans came out, the Division of Insurance was reluctant to approve a lot of them because of the concern over what the out-of-pocket costs could be for the workforce and people in the state, so they dragged their feet on allowing those to happen.”

But that’s changing, Gross said, noting that two or three years ago, high-deductible plans accounted for only 3% of Health New England’s offerings, about half what they are today. And a year or two from now, he expects the figure to be closer to 10% or 12%. “I do see high-deductible plans gaining more steam.

“I think employers are trying to partner with health-insurance plans to find affordable solutions,” he added. “Healthcare is expensive, and there are a lot of expensive medications out there. We all want the latest technologies, but those are expensive too. One way to think about these costs is to share them with individuals.”

In this way, he explained, HDHPs and HSAs fall under the broad category of consumer-directed health plans, which require patients to become much more actively involved in their own care because they’re always acutely aware of what it costs.

“They’re thinking, ‘do I need this service? Are there alternatives? Take prescription drugs, for example; people get tied into thinking, ‘I need this brand-name medicine.’ But if they engage in a conversation with their doctor about generic alternatives, maybe a generic will work in their situation. Another example would be someone with back problems. Do they go right in for surgery, or are there alternative therapies or physical therapy that might be effective? It’s really the consumer driving their own care.”

Employers might be moving toward high-deductible plans partly out of anxiety over the so-called ‘Cadillac tax,’ set to take effect in 2018, that will impose a 40% excise tax on the value of health-insurance benefits that exceed a certain threshold, starting with $10,200 for individuals and $27,500 for families, Binder noted.

“Employers are determined to avoid that tax, but that means slowing growth now or risk blowing the cap by 2018,” she wrote. “Employers used to hesitate to launch unpopular cost-cutting strategies like HDHPs so that they would remain competitive with plans offered by other employers. But pressure from the looming Cadillac tax is felt by all employers equally, so taking a risk on cost-cutting strategies now has less of a competitive disadvantage.”

Wise said the Affordable Care Act, for the most part, hasn’t scared employers, even small companies, off their current health plans, but the Cadillac tax is absolutely a concern.

“I think employers are concerned about the luxury tax coming up,” she said. “If premiums keep going up the way they are, and they would fall under the luxury tax, many of them are going to move to high-deductible health plans.

By All Accounts

At the same time, employers are finding more acceptance of HDHPs among individual consumers because of the combination of lower premiums and the availability of health savings accounts, which offer a number of tax savings, Gross said.

“As an example, I can deduct money from my paycheck and put it into my health savings account tax-free, and that money in the health savings account earns interest — some work like a regular bank account, and with others, you can invest the money. Those earn interest tax-free, and when you spend money [from the HSA] on qualified medical expenses, your payment is tax-free. That’s three ways, from a tax perspective, to save money.”

For consumers who don’t like being hit in the wallet for every single doctor visit and prescription up to their deductible, Health New England offers a hybrid plan — part of its “essential-products suite,” as Gross called it — that features lower premiums and higher deductibles (anywhere from $500 to $2,000) than traditional plans, but covers regular office visits and prescription drugs from the outset. “Because it’s not a qualified plan, you can’t have a health savings account with it, but people are migrating there; 30-40% of our business is in our essential-products suite.”

Gross uses a qualified HDHP and a health savings account himself and appreciates the flexibility it offers, he said. “I put money into it from my paycheck, and I use it as a way to save some money tax-free. I’ve used the savings account to pay for medical expenses — when I went to the doctor, instead of a co-pay out of pocket, I ran my card and paid the whole bill.”

These accounts are owned solely by the individual, and unfortunately, most employers choose not to contribute to them, he noted. “Some employers, a small percentage, may put money into health savings accounts to help employees get started. But the majority aren’t doing that.”

Companies, in fact, are more likely to opt for health reimbursement accounts, which the employer owns, and are typically a use-it-or-lose-it proposition; “if the person doesn’t use the health reimbursement account, the money goes back to the employer.”

Wise agreed, noting that “companies are moving to replace the HSAs, and many of the employers are not contributing to them.”

In short, employers are no different from individual consumers when it comes to seeking healthcare savings. And with high-deductible plans gaining acceptance against a backdrop of rising premiums for traditional plans, that trend looks likely to continue for the foreseeable future.

And that, for better or worse, puts the onus on patients to make decisions that are healthy for both their bodies and their bank accounts.

Joseph Bednar can be reached at [email protected]

Serve and Protect

By BusinessWest Staff February 24, 2015

Insurance Sections

A chart of area insurance companies

Click HERE to download the PDF chart

Policy Statement

By BusinessWest Staff November 4, 2014

Insurance Sections

At AXiA Insurance, Creating Value Is the Rule — Literally

AXiA Insurance Services President Michael Long

Everyone who works for Michael Long follows what he refers to as his “Always Rules.”

They are part of a vision he created long before he opened AXiA Insurance Services Inc. and are the cause and reason behind the laughter that peals frequently from meeting rooms and cubicles in his Springfield headquarters, the smiles on the faces of employees, and the myriad perks, rewards, and awards they receive that range from engraved crystal wineglasses and decanters to unusual birthday gifts they are given at employee-appreciation events.

Their happiness translates into superb customer service, which falls precisely in line with Long’s belief system. “You can’t create value for your customers if you don’t create it for your employees first,” he said, explaining the reasons behind the eight rules he originally created and two he added later.

“I had been in the insurance business for 30 years before I launched this company, and during that time, I saw many valuable employees leave,” he said. “So I realized, if I wanted to be the best agency — not necessarily the biggest — I had to train my employees well and create an environment where they felt valued.

“I consult with my employees about where the agency is going and what is coming next. I also allow them to map their own careers and chart their own destination,” Long went on, adding that he posts the courses and/or certifications needed to move from one position to another and gives employees paid time off to get the education they need to move up in the company.

“What difference does it make to my employees if I am doing well, but they are not moving up with me?” he asked rhetorically. “People want to know what will happen to them.”

The majority of employees work four days a week on a rotating schedule, although they can work five instead if they prefer to do so. But longer workdays result in benefits to clients because it allows AXiA to be open from 7:30 a.m. to 6 p.m.

There are also three ‘snow teams,’ and if there is a blizzard, two of the teams can work from home. In addition, every employee is given two paid days off to volunteer for any charitable organization they choose.

Long’s belief that employees who feel appreciated provide better customer service has led to measurable success, and he has achieved every goal he outlined in the 10-year plan he created before he opened his full-service insurance agency in October 2001. “We’ve averaged more than 15% growth every year,” he said.

AXiA began as a one-man operation in a rented room in Market Place in Springfield. Today the business has 32 employees in six locations that include Springfield, Easthampton, Natick, North Kingston, R.I., and two offices inside MassMutual.

Long makes it a point to understand his employees’ strengths and weaknesses and avoids delegating any duty to an employee that he or she doesn’t truly enjoy or excel at.

“I’ve seen agencies that failed and others that were very successful,” said Long. “But I also saw many skilled and talented people fail because they were told to do things they were not good at. They should be allowed to become great in the areas they enjoy.”

He learned this lesson as a child and said it remained with him as he matured. Long said his mother and teachers did so many things to try to improve his poor spelling that it robbed him of time that would have been better spent focusing on subjects he enjoyed.

“So, what I bring to the table is a different view. I believe everyone has unique abilities, so I try to structure job duties so people are using those abilities,” he said. “The things they don’t do well are passed off to someone else who is great at those tasks and enjoys them.”

Natural Consequences

Long said the rules he created and the happiness of his employees has a direct relationship on the way customers are treated. A positive attitude must start at the top, he said, as he listed his rules, which are:

• Always create value for employees, customers, and vendors;
• Always plan toward the future with reasonable deadlines and objectives;
• Always support the people you work with;
• Always treat everyone with great respect;
• Always seek out education and growth;
• Always keep a positive attitude and outlook;
• Always work with the strengths of others;
• Always look for lessons from mistakes, not blame;
• Always look for and take advantage of opportunities; and
• Always work within your strengths and unique abilities.

“These principles allow us to provide the best service possible at the best price,” Long said, noting that, whenever the cost of someone’s insurance policy goes up by 10% or $100, they are contacted and given alternative options, which is possible because AXiA represents 20 insurance carriers.

Agents also analyze each client’s policies on a regular basis. “Customers are not insurance experts, and sometimes people are paying for things they don’t need, but lack coverage in other areas they should have,” Long said.

He told BusinessWest that the company began conducting annual team reviews for commercial clients two years ago to make sure their policies do not have any gaps or overlaps. They also do a full review of each personal insurance policy every two years, and clients receive a letter about any areas of concern, which are typically sent via e-mail.

“We have 80% of our clients’ e-mail addresses; the average in the industry is only 20%, and we also text information,” Long added. “It’s very important to our clients to communicate with them this way because they are busy.

“But everything we do comes back to my theory and the name of the company,” Long said, explaining that AXiA is a Greek word which translates to “value, capability, merit, worth, and worthiness” in English.

Director of Operations Alana Sambor said the approach makes a difference. “We have already reviewed the policies of more than 2,500 of our clients this year,” she said. “We want to make sure they have the right coverage at the right price, and we publish information we think they need to know.”

Alana Sambor says AXiA goes out of its way to regularly review clients’ coverage to make sure it reflects their needs.

One thing Long believes sets AXiA apart from other insurance agencies is its approach to new clients. “We don’t just ask to see a copy of their current policy and provide them with a quote,” he said. “We analyze it and ask them a series of questions, such as whether they own more than one piece of property, then come back with a report or recommendation about how their policy should look. It’s not an apples-to-apples quote; it’s based on what the person really needs.”

For example, a person may have a $250 deductible on their homeowner’s insurance policy. “But since it’s unlikely they will turn in a small claim, we may advise them to take out a larger deductible and purchase other coverage for things such as backed-up sewers or drains with the money they save,” Long said.

The company also continuously works to improve communications with clients. Two years ago, AXiA put an emergency phone number in place so customers can contact a representative 24 hours a day, seven days a week. “And we are looking at creating a mobile app as well as an interactive website, which we hope to launch next year,” Long said, explaining that it will give clients instant access to their claim history and premiums, so they can see what they paid for a policy years ago.

The new website will also allow commercial clients to issue certificates of insurance for themselves around the clock by logging into the system. “Many contractors, who range from painters to landscapers to truck drivers, need a certificate when they arrive at a new job site, and they often start work at 6 a.m., before we are in the office,” said Sambor. “We have had truck drivers who found they couldn’t leave California without a new certificate, which can be problematic due to the time difference. This will allow them to print whatever they need, any time of day or night.”

Caring Atmosphere

Long promotes his company by having the name AXiA emblazoned on special vanity license plates that are issued to all of his employees. He also purchases shirts, sweaters, and other articles of clothing that display the company name and logo.

But he believes it is his positive attitude and the gratitude passed on to clients by satisfied employees that most accounts for his growth and success.

Sambor noted the company is growing so fast that it interviews at least one new job applicant every month, but added they are very choosy about who works for them.

In fact, before Long hires someone, he spends a great deal of time making sure he or she will fit in well and comply with the company’s rules. “We always want to do what is right for the customer, so our employees must show up on time, finish what they start, and say ‘please’ and ‘thank you’ to every client,” he said.

“When I began my company, I laid out everything that I wanted to do for clients and told prospective employees about my value plan, and the majority of them are still with me today,” he went on. “But it’s a fast-paced environment, so we screen candidates carefully.”

That extends to making sure their unique abilities fit the role they will play in the business. “For example, our receptionist is not only very pleasant, she has real empathy for people. It’s important because she is the first person people talk to, which sets the stage for further transactions,” Long said.

Sambor agrees. “The atmosphere at AXiA makes it a place that is fun to work at, and even the small perks, such as a hot cookie machine and cappuccino/espresso machine, make a difference to employees. We spend more time together every day than most people do with their families, so we need to enjoy our jobs,” she said. “We have a team-oriented environment, and if one person is struggling or engrossed in a project, another person will cover for them while they complete what they need to do.”

Long also publishes jobs on the company website that don’t yet exist, but will be available in the future, as well as pay grades and levels so people know how much money they can expect to make as they advance through the ranks.

He feels that’s important because it helps him retain employees. “I sit down with each of my employees once a year and go over their individual goals,” he said.

The company is dedicated to going green, which has provided employees with additional perks and also resulted in benefits to clients.

“Eight years ago, we began going paperless, so we don’t have rows and banks of file cabinets. We e-mail policies to customers, unless they ask for a hard copy, and we plan to install solar panels in the building,” Long said. He added that allowing employees to work four days a week provides additional fuel savings and reduces emissions.

The company also recently began giving employees partial subsidies for gas if they drive vehicles that get high mileage. “And next year, we plan to do something smaller for the balance of our employees,” he added. “We don’t do things halfway.”

Bottom Line

Long identifies himself as a problem solver, and said it’s the approach he used when he began formulating the principles that would become the cornerstone of his insurance agency.

“I spend time identifying things that could hold us back, and look at situations and find resolutions other people wouldn’t think of,” he said. “I often tease my employees, but I believe people are supposed to laugh at work. If they are having a good time, they are more effective and efficient, and if they like their jobs, they do better at them, which leads to happier clients.”

Cover Story

By BusinessWest Staff November 4, 2014

Insurance Sections

Homeowners’ Liability Often Extends Beyond the Home

By JOHN E. DOWD Jr.

John E. Dowd Jr.

One misconception about homeowners’ liability insurance coverage is that it covers only incidents in the home. In actuality, the comprehensive personal liability (CPL) coverage under a homeowners’ insurance policy is really not associated with any location, other than the limitations and exclusions on the policy.

Here are some examples of what probably would be covered by CPL:

• Sports incidents: for example, you are playing golf and you drive a ball that hits someone in the head and disables them. If you are found liable, as long as you were not doing it professionally, your policy will likely provide coverage.

• After shopping at your local market, you accidentally drop a bottle of olive oil in the parking lot, and it shatters and bleeds the oil onto the pavement. Another shopper comes along, slips, and seriously injures herself on the pavement. While the assumption is that the injured party will take action against the market, the typical practice of attorneys is to go after everyone associated with the incident.

• You are on vacation at a hotel, and you are so excited to leave the room to enjoy a sightseeing tour that you forget to turn off the faucet. The running water causes significant damage to the hotel structure. The hotel decides to go after you for damages. Your CPL will defend you and may pay out damages if you are deemed liable.

• Your kid lends his skateboard to a friend, and the friend, who may not be experienced with the skateboard, gets seriously injured trying to make a maneuver. Parents can be held liable for this injury, and there is a very good chance this will be covered by the CPL coverage.

• If your dog bites a stranger at the park, your CPL will cover you as the owner and responsible party for the dog, as long as the policy does not exclude coverage for your dog breed. Some homeowners policies exclude coverage for breeds deemed dangerous, such as pit bulls.

Additionally, the CPL coverage will usually extend coverage for the following items, even if an incident happens away from the insured premise:

• Trailers that are not attached to a motor vehicle;

• Motorized golf carts;

• Watercraft that does not have a motor or is not more than a specified amount of horsepower;

• Sailboats below a certain length;

• A vacation residence (however, certain conditions may apply, so you also may need to schedule it); and

• Non-motorized bikes.

Here are examples where coverage does not exist and is excluded by nearly every homeowners’ insurance policy:

• Your cars, which are clearly excluded if registered for road use. This is exactly why you need to get a separate auto insurance policy;

• Motorized recreational vehicles, especially if they are off the premises;

• Any incident related to business; and

• Intentional acts.

Policies vary, so it is important to review your policy to see what may be covered and what may not be covered. Additionally, some policies allow you to endorse a coverage that may not be on the policy. This is why it is so important to sit down with your agent to address additional risks you may have and make sure coverage for those risks is addressed.

Liability coverage is perhaps the most important coverage you should have, simply because most of these cases involve attorneys, and if coverage exists, the insurance companies provide for your defense, as well as any settlement up to the limits of your policy. Again, an annual review of your personal risk exposure with your agent is essential. It could be a very short conversation with your agent from year to year if nothing has changed in your life, but more often than not, changes do occur that could expose you unnecessarily to a potentially uninsured loss exposure. Ignorance is never a good defense.

One thing that you should carefully note is that, if you are involved with any activity where you charge a fee of some kind, there is a good chance that the insurance company will deem this to be a commercial exposure and will therefore not cover the activity under your CPL. Your agent or broker is always available to answer these questions, and you should never hesitate to put him or her on the spot.

John E. Dowd Jr. is the fourth-generation president and CEO of the Dowd Insurance Agencies. The Dowd Agencies is a full-service agency, founded by his grandfather in 1898, which provides personal, commercial, and financial-planning needs. The Dowd Agencies has six offices in Western Mass.; (413) 538-7444; [email protected]

Employee or Subcontractor?

By BusinessWest Staff November 4, 2014

Insurance Sections

The Line Is Blurry, but Employers Must Be Careful Not to Cross it

By BILL GRINNELL

Bill Grinnell

As business owners, our quest for increased efficiency and cost-effective solutions has led many of us to hire subcontractors. It often makes sense to subcontract for work outside of your expertise or for extra work during abnormally busy times of the year.

From an insurance standpoint, subcontracting work has advantages. A sole proprietor with no employees is not required to have workers’ compensation insurance in Massachusetts. Thus, this cost is eliminated by subcontracting work within the law.

But subcontracting work within Massachusetts law is much easier said than done.

Massachusetts Is Tougher Than the IRS

The laws governing subcontracting are much more complicated and stringent in Massachusetts than they are on a federal level. The IRS is the government agency that determines whether a worker is an employee or an independent contractor, due to the tax implications of the determination.

The IRS has a list of 20 factors it uses to determine a worker’s status. The factors pertain to how, when, and where the work is performed. Some of these factors include:

• Whether a worker must comply with the employer’s instructions for the work;
• Whether the employer provides specific training;
• Whether the worker must comply with hours set by the employer; and
• Whether the worker is on the job full-time.

In Massachusetts, the law presumes that everyone you hire is an employee until proven otherwise. You’ve heard of innocent until proven guilty? Well, in Massachusetts, every freelancer you hire is an employee until proven an independent contractor.

Misclassification Is Costly

Misinterpreting the laws can have unexpected and costly consequences. Employers found to have misclassified an employee as an independent contractor may be subject to income-tax liability for withholding that should have occurred with wages that should have been paid, FICA and FUTA contributions, state unemployment-contribution payments, potential overtime and other wages owed, workers’ compensation insurance premiums, and civil and criminal liability.

Non-willful violations of the law can incur fines of up to $10,000 and imprisonment for up to six months for a first offense. For violations found to be willful, the fine can rise to $25,000, and imprisonment can last up to one year for a first offence.

To steer clear of these landmines, ensure that your subcontractors qualify as independent contractors.

Three Critical Tests for Independent Contractors

In Massachusetts, there are three critical tests workers must pass to be deemed independent contractors: They must be free from the employer’s control, they must work outside the employer’s usual course of business, and they must do the same work regularly for other companies.

Freedom from Control
A worker must be free from the presumed employer’s control and direction in performing the service, both under a contract and in fact. To be free from an employer’s direction and control, a worker’s activities must be carried out with independence and autonomy. For example, workers should provide their own tools, set their own hours, and take their own approach to completing a job.

In the old days, paper-delivery boys and girls were deemed independent contractors. Today they are considered employees, and we no longer see young kids delivering papers door-to-door.

Work Must Be Outside the Usual Course of Business
To qualify as an independent contractor, the worker’s job or service also must be performed outside the usual course of business of whothat performs work that is part of the normal service delivered by the employer may not be treated as an independent contractor.

Here’s where the lines get sketchy. I have seen nightmares created by insurance-company auditors. If a home builder hires a plumber, is that outside of his usual course of business? Some insurance auditors interpret this law very strictly and take the position that any construction activity performed for a general contractor is in the same course of business. Thus, the auditor makes a charge for any uninsured subcontractors.

Work Must Be Done Regularly for Others
Third, an independent contractor must represent himself or herself to the public as being in business to perform the same or similar services. Furthermore, an independent contractor often has a financial investment in a business that is related to the service he or she is currently performing for the employer.

For example, if a restaurant were to hire the same driver to pick up meats and fresh produce every day and that driver only drove for that one restaurant, an employee relationship would exist.

Make sure your subcontractors pass all three tests to ensure that you will not be hit with penalties and saddled with a higher head count than you wish.

If you have questions about your subcontractor relationships, contact an insurance professional.

Bill Grinnell is president of Northampton-based Webber and Grinnell Insurance Agency; [email protected].

Serve and Protect

By BusinessWest Staff November 4, 2014

Insurance Sections

A chart of the region’s Insurance Agencies

Click here to download the PDF

Family Plan

By BusinessWest Staff September 9, 2014

Insurance Sections

T.P. Daley Insurance Navigates a Changing Industry

From left, Tom, Kathy, Anne, and Jim Daley, second-generation principals at T.P. Daley Insurance Agency.

Insurance is certainly in the Daley family’s blood. But their father wanted them to be certain.

“Our father made sure we all worked somewhere else first,” said Anne Daley, one of four principals at T.P. Daley Insurance Agency, along with her siblings, Jim, Kathy, and Tom Daley.

In fact, all four of them were interested in joining the company their father, Thomas P. Daley, started, but he wouldn’t allow them to make the firm their first job. So they cut their teeth at large companies like Aetna, Travelers, and John Hancock.

“He wanted to make sure we liked the business and learned the business; he didn’t want us to come in as the boss’s kid,” Anne added. “That was the message: ‘get a little background prior to coming here. If you hate it, hate it with someone else; don’t hate it with me.’”

None of them, it turned out, hated the insurance field, and between 1985 and 1990, all four came on board, and run the second-generation family business in West Springfield to this day.

“It’s scary that we all ended up in insurance after graduating,” Kathy said, “but we all wound up here.”

They have fond memories of growing up around Thomas Daley’s workplace.

“When we were young kids, Dad used to call on all his customers, and he’d take us with him,” Jim recalled. As it happened, most of those clients were in construction, as Daley focused his business on performance bonds in the construction field. “So we would climb on all the equipment. I don’t remember how many times he’d be talking to the owner, and we’d be climbing on loaders and excavators. I remember coming home filthy, and Mom saying she’d never get the grease out of my coat.”

“We really did grow up with it,” Anne added.

With the help of the GI Bill, their father graduated from the University of Rhode Island, which at the time boasted the only insurance school in the Northeast, Kathy said.

He was a bond manager for Aetna in Springfield during the 1950s when he decided to start an independent insurance agency and become a bond producer rather than work for someone else as a bond representative, Jim explained. So, at the dawn of the ’60s, he and partner Bill Tuttle opened Daley & Tuttle Insurance on State Street in Springfield.

“Then Bill wanted to go to Eastern Mass. and focus his sales pursuits there,” Jim said. “My dad really liked the more parochial nature of Western Mass., so they decided to split up. T.P. Daley started in 1963, just him and one employee.” They moved the business across the river to Park Avenue in West Springfield, then relocated to their current location on Westfield Street around 1981 — the former site of Sweenor’s Candy.

“People come in and say, ‘I can still smell those bon bons,’” Jim said, standing beside a long counter where the Daleys still set out bowls of candy. “This is where the glass was, where they sold candy.”

But it’s not candy running through he family’s veins, Jim said, but insurance; in fact, he met his wife at a four-day-long ‘bond school’ in Texas. Simply put, this is a clan that truly enjoys the business their father started, and for this issue’s focus on insurance, they sat down with BusinessWest to explain why.

Bonding Agents

While the company has diversified considerably since its early days, T.P. Daley still specializes in bonds for contractors. “It’s not really an insurance product,” said Jim. “It’s a financial guarantee that the contractor is going to bid the job according to plan and then complete the job according to plan.

“The key focus for us is still contractors,” he added. “We do an awful lot of construction risk, both in insurance and bonds.”

The industry has changed quite a bit since the 1960s, however, a time when the surety world wasn’t set up to handle very large contracts. “So he had to go out and buy reinsurance for different layers of the contract size.”

Also, Tom noted, “he didn’t go through agents; he went directly to the customer. Now a lot of that is handled through agents.”

Despite the changes, Anne said — and there’s a tremendous variety today of what bond companies will accept — T.P. Daley still succeeds by fostering relationships, even though insurance products are viewed more and more like commodities, with clients in search of the cheapest price. “Although the field has grown and evolved tremendously, it’s still a relationship business here.”

She noted that there weren’t a lot of bond agencies when her father started out, and very few locally. “That has changed over the past 10 years — there are more agents in the area, and more agents in general working in the bond field.”

The agency’s location for the past 30-plus years is the former site of Sweenor’s Candy, which many customers remember well.

That means a much more competitive playing field, Jim said, which is a far greater challenge today than it was when the construction industry was rolling along throughout most of the 2000s. Even when the financial markets crashed in 2008 and triggered the Great Recession, contractors remained busy for awhile.

“Construction kind of lagged, so the industry was still rolling in ’08, ’09, even into ’10,” he said. “Those were good years for most contractors.”

But once backlogs were depleted, times got tough, and remain so today. Contractors have had to “sharpen their pencils” and cut their margins, he explained, and insurance companies heavily invested in construction have felt the pressure. “If there was more work, we’d see the margins come up, but there’s so much competition for the amount of work available out there that the margins have not recovered to their prior levels.”

The situation has been exacerbated, Jim added, by the fact that the government has been reluctant to access funds from the Chapter 90 Program, which pays for infrastructure-improvement projects in Massachusetts, and cities and towns have been loath to dip into their own budgets, “so you’re seeing deteriorating infrastructure; that’s exactly what’s going on.”

Rest of the Story

Fortunately, T.P. Daley’s array of products has widened considerably since the agency’s early days, encompassing a range of both business and personal lines, including home, auto, and life.

That side of the business has undergone changes as well in recent years, particularly with Massachusetts moving from set auto-insurance rates to a managed-competition system in 2008.

But while the Geicos of the world attract consumers with that last $10 off their premium, Anne said, “people buying online have to be astute.”

“They need to know what they’re getting for their dollar,” Kathy added. “A lot of times, people come in here, and we have to explain to them what they’re getting, what they’re protecting. We find that a lot of younger people buying online don’t know what they’re really getting — they just know it costs $400. You have to be educated, and that’s where we come into play.”

Or, as Jim put it, “we don’t want them to find out the hard way that the deductible was $1,000, when they thought it was $500.” Or that they didn’t include collision among their coverages.

“That’s the importance of an independent agent,” Anne said, “to explain what the coverages are, and then you decide what your needs are.”

Added Jim, “it’s more than just buying coverage. All those coverages mean something. It’s not just about the dollars. At the point of sale, that extra money in your pocket sounds like a good idea, but the financial consequences for saving a few dollars could be dramatic.”

That’s just one example of how customer service remains a valuable commodity at T.P Daley Insurance, Anne told BusinessWest. “That’s probably one of the key elements of this agency, our customer service. When you call, you deal with a family member.

“We’re literally 24/7,” she continued. “We give out our cell-phone and home numbers. Especially in the bond business, sometimes you need something tomorrow. I think that sets us apart from other agencies — our love of the service.”

Tom said it all goes back to Thomas Daley never turning anyone away. “Even if it was a tough situation, he always tried to help. He said, ‘give me your papers, and let me see what I can do.’”

Anne said she advised a client on insurance products for six years before writing a policy. “They’d call with questions, and I’d help out any way I could. I knew them from high school. Ultimately, when they needed to make a change, they came to us.”

The Daley siblings hope customers keep coming, and they sense some interest among their own children in turning the business into a third-generation affair someday, but they also know it’s a challenging field, and, like their own father, they want their kids to be sure.

“This is a changing industry, and I think there’s a lot more pressure on people now than there was 20 years ago,” Anne said. “It’s not an easy business, but it’s rewarding.”

Jim agrees. “There have been some dynamic changes from the old-school days to now,” he said. “That’s not to say it’s lost all its luster; it’s still got some positives that make you want to come to work. And I think people here enjoy coming to work.”

Even if they don’t get to climb on heavy machinery anymore.

Joseph Bednar can be reached at [email protected]

Protect and Serve

By BusinessWest Staff September 9, 2014

Insurance Sections

A chart of the region’s insurance agencies

Click here to download the PDF

Cost of Living

By BusinessWest Staff June 3, 2014

Insurance Sections

Long-term-care Insurance Is Crucial, but Often Expensive

Patricia Grenier doesn’t miss an opportunity to talk about long-term care — and the insurance products available to pay for it.

“I talk about it with every client who crosses my desk,” said Grenier, general partner with BRP/Grenier Financial Services in Springfield. “I discuss how they’re going to take care of themselves, what their plan is for long-term care, and we discuss all the options; they can self-insure. They could give away all their money and live off the state, but who wants to be poor? That’s not the goal. They could move in with family — usually their kids — but nobody wants that.”

As Baby Boomers surge into their retirement years and Americans are living longer, on average, than ever before, the rising cost of long-term care — which may include everything from home care to assisted living to skilled nursing care — is not a matter to be taken lightly. The cost projections, for all tiers of care, are daunting.

In fact, according to Genworth Financial, the largest seller of long-term care policies with roughly 35% of the market, the median annual costs of care in Massachusetts are:

• $126,290 for nursing-home care in a semi-private room, or $134,320 for a private room, with costs rising about 4% per year;

• $62,964 for a one-bedroom assisted-living unit, rising about 4% per year;

• $57,200 for a home health aide, or $52,625 for homemaker services, costs expected to remain fairly steady; and

• $16,900 for adult day healthcare services, with costs rising about 3% per year.

In other words, the costs rise steeply with the level of care required, and these are numbers that most Americans are simply unable to handle on their own.

“Unfortunately, very few people are prepared to deal with this risk, as less than 8% of people have long-term-care insurance, and only 10% of people in the U.S. have a long-term care plan in place,” notes Jamie Hopkins, who writes about retirement-income planning for Forbes. “This lack of planning is extremely troubling because long-term care is a very real and expensive risk, as nearly 70% of people will need long-term care at some point.”

Frank Carrazza, director of Financial Planning at St. Germain Investment Management in Springfield, said there are many reasons why people put off buying long-term-care insurance.

“We all know that, once we get older, it would be nice to protect ourselves so we don’t have to lose our assets,” Carrazza said. “The ideal time to buy, for most people, is probably between 50 and 55, when premiums are reasonable. But at ages 50 to 55, they’re not thinking about retirement that much, and they’re still accumulating for retirement. When people get to age 65, 66, 70, they may re-evaluate.”

By then, however, premiums are more expensive.

“Let’s say you want to buy a long-term-care policy in the area of $250 to $300 a day. It’s very expensive. On average, a 65-year-old couple, if they’re in good health and non-smokers, might pay $6,000 to $8,000 a year, depending on the benefits. A lot of people can’t fit that into their budget. Or, people with substantial assets, who can afford it, might not pay for it, but figure they can use their own resources later on.”

Tough Decisions

Dan Caplinger, director of Investment Planning for the Motley Fool, says the idea of decades of ‘sunk costs,’ never to be recovered, worries people, especially when rates go up.

“Insurance agents typically advise people to obtain long-term-care insurance as early as possible to reduce costs, as premiums are much lower for younger policyholders who are less likely to need benefits in the immediate future,” he writes. “What that means, though, is that those who’ve held onto their policies a long time have already paid tens or even hundreds of thousands of dollars in policy premiums without having gotten a dime in benefits to show for it.”

And when faced with possibly hundreds of dollars in extra premium payments each month, many people — especially those on a fixed income — find themselves trapped by the spectre of the rate increase. “That will prove an impossible task, and they will have to accept lower benefits or even give up their policies entirely — thereby having essentially wasted all the money they’ve spent on premiums for years.”

Howard Krooks, an elder-law specialist in Florida, told the New York Times that he advises clients faced with an increase of 20% or less to “bite the bullet” and pay it, even if they think it was unfair. If the increase is much higher, they may consider reducing their benefits — for instance, by accepting a daily benefit amount of $250 a day rather than $350 — to keep the premium down.

Pat Grenier says she makes a point of talking to virtually every client about long-term-care insurance.

And those rate increases keep coming. Genworth began seeking increases on its existing policies in 2012, with the goal of raising between $250 million to $300 million in additional premiums by 2017. Meanwhile, Grenier said, John Hancock is raising rates by up to 50%. “That’s amazing. And I think Genworth is going to gender underwriting, where before it was unisex. Now women are more expensive — because, statistically, women still live longer than men.”

A new trend, Carrazza said, is an option for a large lump-sum payment — say $50,000 — which is refundable if it’s never used, as opposed to a monthly premium, which customers typically don’t get back.

Whatever the product, he added, the market is becoming tougher for customers, with higher rates, lower benefits, and fewer options available than there were years ago.

“Fewer companies are offering the product, and those fewer companies are now underwriting the product,” he explained.

“What that means is, if someone wants to apply, instead of just filling out an application and having a telephone interview, in most cases, people are required to complete a paramedical exam — the same type of exam taken for a life-insurance policy. Insurance companies are losing money with the product, so they’re raising premiums and underwriting the product to improve their claims experience. And, from a customer point of view, that makes it harder to get the product.”

Insurance companies say the changes are necessary. Caplinger noted that they paid out almost $7.5 billion in claims for long-term-care benefits in 2013 — a 13% rise from the previous year, with benefits going to 273,000 policyholders across the nation. He cited another study projecting that current benefit payouts will double by 2023 and rise to $34 billion by 2033 as more people start accessing their policy coverage.

Expensive — but Necessary

Despite the expense, long-term-care insurance remains a critical product, said Grenier, who said the ideal age to purchase it is in one’s late 50s or perhaps early 60s.

“It’s absolutely a necessity,” she told BusinessWest. “A couple could spend around $250,000 a year [on care]. That’s a lot of money. So I do talk to everyone about it.”

There are some creative options for families willing to sacrifice together, she said, noting that she and her siblings actually pay the premiums for their parents’ long-term-care insurance.

“Many times, people who are retired have a hard time making ends meet. For me, I’d rather pay a premium now on a monthly basis than come up with tens of thousands of dollars later on. I look at it as a family issue.”

Grenier joked that the decision was partly a “selfish” decision, to avoid huge out-of-pocket expenses later, but quickly got back to the idea that her family wants to make sure their parents are cared for.

“Obviously, we want them taken care of well, and that could be more expensive than just paying a monthly premium today — and, of course, I have siblings helping out,” she said, adding that, in many families, especially those scattered around the country, one child takes the lead in caring for — or financing the care of — a parent, which can cause rifts and resentment in the family.

“It’s very difficult when one lives in California, and you’re in Massachusetts. How do you handle that care?” she said. “In the old days, our elders lived with us. Now, that doesn’t happen. And the government doesn’t have the money it used to have; we are responsible for ourselves.”

Other options exist for paying for long-term care, Hopkins notes in Forbes, including reverse mortgages and income annuities.

“While self-funding, long-term-care insurance, Medicaid, and family-provided care will continue to be the primary sources of long-term-care funding for the foreseeable future, the market is changing, and more people are becoming aware of these new and alternative ways in which to pay for long-term care,” he writes. “Whatever avenue you decide to take, having a plan in place is crucial.”

Grenier agreed. “It’s a rising trend. It’s a need for more people, I think more people are aware of it, and more people are buying it.”

Even as rates continue to rise.

“Long-term care is going to get more expensive,” Carrazza said. “That’s the really sad part about it. It’s difficult.”

Joseph Bednar can be reached at [email protected]

To Serve and Protect

By BusinessWest Staff June 3, 2014

Insurance Sections

Nathan Agencies Have a Host of Client Needs Covered

Glenn Allan, Anna Holhut, and Dean Paddock offer a diverse array of insurance products to individuals as well as business owners.

Ron Nathan says many people think they are secure, while others don’t worry about their financial futures in the event of a calamity. But the first assumption can be erroneous, and the second approach can result in financial devastation.
“I’ve grown up seeing a lot of people who are totally unprepared for a catastrophic situation, like a death in their family,” he told BusinessWest. “Others save for something specific, such as their children’s college education, but don’t think about their own retirement because they are so focused on one goal. Then, when it comes time to retire, they realize they never planned for their own future.”
Thus, he has dedicated his life to preventing such scenarios from becoming reality, and is proud that the Nathan Agencies in Amherst, which began as a small firm 45 years ago, have grown steadily over the years, offering one-stop shopping to meet people’s insurance and financial-planning needs.
Three companies — Amherst Financial Services, Amherst Insurance Agency Inc., and Andrew Paddock Insurance Agency Inc. — make their home under the agencies’ umbrella on 20 Gatehouse Road and have well-educated employees who strive to help clients plan for and protect their financial futures. Together, they offer comprehensive services and products that range from financial planning, investments, and estate planning to life insurance; long-term-care insurance; auto and home insurance; renter’s insurance; business, health, and disability insurance; and other forms of commercial insurance.
Nathan said many clients do all their business under the umbrella, but others have policies with different agencies or have their own financial advisors. But his passion for helping people has no boundaries, and if he discovers they don’t have adequate coverage, he makes them aware of what they need, then advises them to call their own agent.
“You need to look out for people’s best interests and help them,” Nathan said, adding that he is concerned that schools don’t provide young people with the education they need to manage their finances, “never mind how to invest money. And it’s so important.”
Nathan said exceptional customer service is the foundation of his firm’s success and accounts for the extensive number of awards it has received. “We go above and beyond and do things such as assisting people with insurance appeals to avoid a surcharge,” he said, as he spoke about services provided following an auto accident.
Anna Holhut agrees that clients need help whenever they suffer a loss. She worked for Nathan for decades before she and Glenn Allan purchased Amherst Insurance Agency from him in 2012. “We’re not related to Ron, but we still run it like a family business,” she told BusinessWest.
She recalled going to the scene of a house fire immediately after receiving a call from the building inspector. The homeowner had given him her name and number as he was readied for transport to the hospital via ambulance.
After leaving the house, Holhut visited him in the hospital. “I wanted him to know that his pets were in good hands as well as how he could get back into the house,” she said. “When there is a loss or problem, we really come to the plate.”

Growing Enterprise
In 1969, Nathan founded the Nathan Agency. He had moved to Western Mass at age 21, was selling life insurance to college graduates and graduate students at UMass Amherst, and liked the area.
At the time, the young agent faced significant competition, but he worked four nights a week as well as during the day, which soon led to success.
In the early years, life insurance was his primary product, but by the ’70s, Nathan had begun to expand his product lines. As a result, the firm experienced steady growth, and in 1978, he moved from Pray Street in Amherst to his company’s current location.
A year later, when the owner of Amherst Insurance and Real Estate Agencies became ill and left town, he purchased that business and changed his company name to the Nathan Agencies.
Although he had earned his stockbroker’s license at age 23, it wasn’t much use to him at the beginning of his career, as the college students to whom he sold life-insurance policies did not have money to invest. But after the move to Gatehouse Road, Nathan began thinking long-term.
“I envisioned creating a one-stop shopping place where people could get competent professional help in all areas of insurance and financial planning,” he said.
To that end, he persuaded an attorney to move into the building, and in 1987, he earned a degree as a chartered financial consultant from the American College of Financial Services.
In 2001, the Nathan Agencies expanded again when the Andrew Paddock Insurance Agency Inc. moved into its building. The expansion came about as a result of relationships Andrew’s son, Dean Paddock, had formed with Nathan, Holhut, and Allan. “I had taken over my father’s business in 1990 when he retired, and in 2001, I decided to move the business from Hadley and join Ron, Anna, and Glenn,” Paddock explained.
Today, even though Nathan has realized his dream and is proud that Nathan Agencies offers a wide array of products and services, he still focuses considerable energy on the product he started with — life insurance.
“It should be part of everyone’s financial planning, but many stockbrokers and people with investment backgrounds don’t believe in it or really understand life insurance and its benefits,” he explained. “But people need to have a lot of things in place to be secure — an attorney, a will, guardians for their children, and insurance coverage for their mortgage if they die.
“They also need to think about disability insurance, and, as they get older, they should think about long-term-care insurance,” he went on. “And if they accumulate wealth, they need to make sure they have proper liability in their auto and homeowners’ policies because, if someone sues you after an auto accident or after they slip and fall in your home, you could lose all your assets.”
The trust he has built with clients, a hallmark of the Nathan Agencies, is reflected in relationships formed by employees in all three companies. The businesses continue to grow, and Nathan attributes part of this success to the fact that his broad enterprise is family owned.
“Many family-owned auto and homeowners’ insurance companies have been purchased by other firms and become more of a retail business,” he noted. “But I believe very strongly in personal service, which started with the fact that I grew up in the life-insurance business and brought the same concepts I used with those clients into the property and casualty agency.”
Today, his continued focus on educating and protecting people has made him concerned about people who purchase insurance via the Internet.
“I don’t think it’s necessarily by choice or because they want to,” he told BusinessWest. “It’s because they don’t know where to go, and, as a result, an enormous segment of the population is not getting any financial planning advice or help with insurance.
“But we are a source for that,” he continued. “We have developed trust on both sides of the agency, and because most of our staff has been here for so long, they have had the opportunity to grow in the direction they enjoy the most, and are experts in their field.”

Community Service
Nathan has seen many people suffer as a result of their failure to protect themselves financially.
“So we try to protect people on all sides; the whole concept of our agency is a one-stop place to shop,” he reiterated, adding, “I started from scratch and was the smallest agency in Amherst. Today, we are not the largest property and casualty agency, but between both sides of our business, we do as much business as anyone in the Pioneer Valley.”

Mind the Gap

By BusinessWest Staff February 25, 2014

Insurance Sections

At Webber & Grinnell, the Devil Is in the Details

Bill Grinnell says his job is to protect businesses, and education is a big part of that.

The sales pitch at Webber & Grinnell Insurance often comes down to one simple question: what are you not covered for?

“That’s part of our renewal process, focusing on what coverage is lacking,” said William Grinnell, who, along with Richard Webber, has led this Northampton-based insurance agency to steady growth for almost two decades. “Business owners get a sense of where they’re exposed, and what they really want to know is what they’re not covered for.”

Take, for example, the broad realm of business-practices liability.

“That’s a huge one,” said Mat Geffin, vice president of business development. “They think, if they’re sued by an employee, their general liability coverage protects them. It won’t. There are exclusions for employment-practices types of claims, like sexual harassment and wrongful termination — those are a totally separate type of policy, completely excluded under your general liability.”

And, in an ever-more-litigious society, that’s no small matter for an employer.

Those suits are frequent; my clients have seen a lot of those this year,” Geffin said. “The more employees you have, the more turnover, the more likely it is that these suits will occur.

“It’s a huge risk,” he added. “I’ve had clients who have done all the right things in terminating a problem employee, but nothing’s stopping them from going to Mark E. Salomone and filing a lawsuit. That’s where that employment-practices policy steps up to protect the company.”

Sometimes, Grinnell noted, employers think they’re doing everything right and don’t believe they’re exposed. “But anyone can sue for any reason, and defense is very expensive and time-consuming” — often to the tune of thousands of dollars small businesses just can’t spare.

Fortunately, he added, the agents at Webber & Grinnell are trained to think like underwriters; in fact, even the most dynamic salespeople won’t get hired if they aren’t able to dig into the fine print of an 80-page policy, understand its strengths and weaknesses, and make sure clients understand them, too (more on that later).

“We help them understand that everyone out there has different risk tolerances,” Grinnell told BusinessWest. “Our job is to help them make an informed decision about what insurance they’re going to purchase.

“Our obligation is, obviously, to protect those businesses,” he added. “They had better be protected right, or we’re exposed, too.”

Digging Deep

Grinnell said his agency focuses on the property/casualty market. “Our main lines of coverage are workers’ compensation coverage, commercial property, and general liability,” as well as home and auto insurance.

On the business side, he said, some nuances have changed the game over the past decade or so. For example, workers’ compensation has become much more complex, and many employers’ policies are fraught with mistakes in classification or experience modification calculations — although companies are becoming more savvy on these matters.

Mat Geffin says cyber liability is one of the hot insurance trends that companies of all kinds need to be aware of.

From a liability standpoint, said Geffin, there’s more of a trend toward cyber liability, with more companies, especially retailers, doing business online. “It’s an area of growth in the insurance industry — you see all these lawsuits; you see Target losing millions of customer records,” he noted. “What happens when small businesses in this area are being hit with some of those exposures? They’re not all covered for it, and that’s the new thing we’re talking to people about.”

On the personal-lines side, Grinnell said business is always changing. “It’s been ever-more competitive with the introduction of competitive auto rates several years ago, so we battle with that.”

In the midst of such competition, Geffin said, “I do believe a differentiator for us is our knowledge, being a pure coverage insurance agency. We’re not out there just hawking prices. We really do take a hard look at the coverage, talk intelligently, take an underwriter’s approach to it. Bill and Rich were both underwriters, and were trained to look at risks like underwriters.”

Indeed, Grinnell’s first job after graduating from college in 1984 was with United States Fidelity and Guarantee Insurance in Boston. He received in-depth training there, which provided him with advanced knowledge of how policies are constructed. Webber had similar training experience at Aetna as an underwriter, and Grinnell attributes most of the company’s success to an ability to carefully examine policies, because, while clients are expected to read their policies, he realizes that they don’t always understand them.

Grinnell purchased his father’s agency, then known as Woodward and Grinnell, in 1997, and soon after teamed up with Webber. Their relationship has been synergistic, with Grinnell focusing on sales, and Webber spearheading office adminstration, technology, and relationships with larger carriers. Last fall, Grinnell became the company’s sole owner, and Webber is now vice president of operations.

Unlike insurance agencies that use a cookie-cutter approach to policy writing, Grinnell said, his salespeople are required to take a highly individualized approach.

“Everyone has different problems, and you’ve got to identify what the issue is and then capitalize on it,” he explained. “It might be a service issue, it could be a problem they had with a claim, a coverage issue … any of these things.”

One of the firm’s advantages is the number of commercial markets it represents, he added, and the leverage that brings. “As opposed to a smaller agency, we have dozens of different commercial insurance companies to approach, and we can get a good, competitive package from one of them.”

Knowledge Is Power

But Webber & Grinnell brings knowledge and information to its clients beyond crafting their policies.

Significantly, the company sends clients something called Business Digest, a national insurance newsletter agencies personalize according to their own needs. “Sometimes it contains timely topics concerning insurance coverage,” Grinnell said, “and sometimes it focuses on insurers and best practices and what we’re doing well to manage a particular risk they might have in their business.”

Over the years, the firm has also established informational hotlines for OSHA and human-resources matters, a workers’ compensation hotline staffed by an attorney in that field, and seminars on topics ranging from sales fundamentals to hiring rights to corporate leadership — all these efforts geared toward moving beyond the insurance relationship and becoming more of a partner with clients, to help their businesses run smoothly.

All those efforts are part of growing Webber & Grinnell, both in size and in scope of services, Geffin said. “We have a lot more competition that has come in with the direct writers, like Geico and Progressive. But we’re trying to grow.”

One reason that’s a challenge, Grinnell said, is that the agency is extremely cautious in its hiring process. “We’re very selective about who we take on. We’re trying to find a salesperson who fits our culture, and it’s very difficult. We get a lot of people in the door, but we don’t take many.”

The reason has to do with the dual nature — personal and technical — of what the company demands.

“You’ve got to be bright, and you’ve got to work hard,” he told BusinessWest. “And you’ve got to be a person who’s able to handle the technicalities of the insurance world and all the little details in the policy, and, at the same time, get along with people, communicate well with people, and build firm relationships.”

Geffin agreed. “It’s very much a hybrid type of role,” he said. “A lot of salespeople are not good at the technical standpoint, that other side of reading the contract language and interpreting the contract language. There might be hundreds of pages, and 100 ways you can write it depending on the risk. You need a very special person, and it’s very hard to find that mix.”

Even for employees who don’t deal directly with clients, the standards are high, Grinnell said. “Internally, we’re looking for a slightly different skill set, but, again, we test everyone who comes in here, interview them several times, check their references. We’re very selective about hiring. And I think that gives us an advantage.”

Giving Back

With so many human needs in Western Mass., the company also has to be selective about its charitable efforts, which Grinnell said have long been a part of the agency’s culture. These days, for example, Webber & Grinnell heads up campaigns for United Way of Hampshire County and United Way of Pioneer Valley, among other efforts.

“I don’t know if this is true for a lot of agencies, but we do a lot philanthropically in the Valley,” Geffin said. “It’s a huge commitment. Bill and Rich have always led by example, by giving back to the community that supports us. I think that’s a good message.”

It’s just one more detail that this insurance company strives to get right.

Joseph Bednar can be reached at [email protected]

Guaranteed Promise

By BusinessWest Staff February 25, 2014

Insurance Sections

Phillips Insurance Agency Specializes in Surety Bonds

Joseph Phillips says the bonding process, while complex, should be considered an opportunity for businesses, not an obstacle.

Joseph Phillips is drawing a triangle to illustrate how a surety bond works. One leg is upheld by a contractor, and the other is held by a bonding company. The business owner, city, or agency that hired the contractor sits at the top.

The president of Phillips Insurance Agency in Chicopee explained that a surety bond is a type of guarantee, and if the contractor fails to complete a project, the owner can go directly to the surety bonding company to remedy the situation. “Surety is defined as a third-party guarantee, and the surety bonding company guarantees that the contractor will perform the work as stated in the contract,” he said, adding that this includes paying subcontractors and suppliers.

Although the concept is not difficult to understand, Phillip says confusion and misperceptions exist about the prequalification process required to post a bond. He admits it takes time and can be frustrating, but contractors who complete it have an edge in an industry that has become increasingly competitive. Bonds allow contractors to work in both public and private sectors and thus weather changes in the economy during an era in which more and more owners and banks require that projects are bonded.

Phillips is passionate about his work, and he and his 18 employees have spent close to two decades educating and helping clients complete the bonding process, which many don’t attempt because they consider it too complex or difficult.

But Phillips says it is a good investment of time. “People should not consider it an obstacle, but an opportunity to expand their business,” he told BusinessWest.

He has been dealing with surety bonds since he graduated from college, and today, due to his efforts, Phillips Insurance has become one of the largest bond and construction insurance writers in the Northeast. “We have the same expertise in surety bonds and risk management for contractors as our competitors in New York and Boston, and can respond to needs whether they are simple or complex,” he said.

Although his agency also writes automobile, home, and business insurance policies and serves 150 clients in 12 states, 80% of its work is with bonds.

Phillips does what it takes to attract and retain clients, and that includes meetings at 5:30 a.m. in a wide variety of places, including airports. “I’ve written bonds for contractors in Las Vegas whom I have never met,” he said.

Bond Administrator Jocelyn Keech is one of 20 employees at Phillips Insurance Agency in Chicopee.

He takes great pride and satisfaction in connecting clients with the companies that offer these third-party guarantees. What sets the company apart from the 38,000 other insurance agencies in the U.S. is that it is a member of the National Assoc. of Surety Bond Producers, Phillips said, adding that the organization has fewer than 500 members due to the difficulty of fulfilling its requirements. He is past president of the Surety Assoc. of Massachusetts, and has earned both his AFSB (associate in surety and fidelity bonding) and CRIS (construction risk and insurance specialist) designations.

Phillips advises contractors who are unfamiliar with the bonding process to visit his agency’s website — www.phillipsinsurance.com — and read the publication link titled “Your First Bond,” as well as other educational material posted there.

Changing Direction

Phillips Insurance Agency celebrated its 60th anniversary last year by giving $1,000 each to 10 nonprofits that were nominated by their clients, then voted on by the public. Winners included the Boys & Girls Club of Chicopee, the Constanza Medical Mission, the Assoc. for Community Living, the Sisters of St. Joseph, Camphill Village USA, and others. In addition, the agency donated $1 to Shriners Hospital for every ‘like’ it received on its Facebook page.

The company dates back to 1953, when Joseph’s father, Cornelius Phillips, purchased the William J. Fuller Agency in Chicopee. The Fuller Agency had been in business since 1898, and Cornelius renamed it and chose to focus on auto and home insurance.

A major shift occurred when Joseph took the helm after his father’s death in 1997 and put his focus on the surety bond market.

He had worked for Fidelity and Deposit Co., which is the oldest bonding company in the U.S, after graduating from college, then was employed as a bond writer for Liberty Mutual before he returned to Chicopee to join his father in business.

The company has always valued its employees, and when Joseph joined his father, there were only two employees. They included 52-year-old Jeanne Jones, who was employed by Cornelius at age 16 and is still working at the agency.

“We also have three employees who work remotely,” Phillips said, noting that he chose to keep these individuals when they moved from Western Mass. to distant states.

Phillips also places a high value on education, so the agency’s website contains a wealth of information about the bonding process. In fact, he finds great satisfaction in helping people obtain their first bond.

“It’s intimidating for small companies — the process can be confusing, and many people don’t think they can get a bond,” he said, adding that the agency receives a number of referrals from local certified public accountants and commercial lenders. “But if the person goes through the steps and understands what is required, they leave behind a slew of competitors who failed to do what is required to bid on public projects.”

Phillips said surety bonds resemble an extension of a line of credit at a bank, and the practice of issuing them dates back to ancient Egypt. They have been used throughout U.S. history as well. In fact, Franklin Delano Roosevelt was bond manager for Fidelity and Deposit Co. in New York from 1921 to 1928 before he was elected president in 1932. Three years later, passage of the Miller Act in the U.S. made it a legal requirement for a bond to be issued for all federal public works projects that exceed $100,000.

Phillips admits that trying to get a bond for the first time can be a frustrating process for people who don’t understand what is needed. “When a surety company underwrites a new account, they are looking for the three Cs — capital, capacity, and character — or the moral and ethical nature of an individual or business entity,” he said. He defines ‘capital’ as a measure of the contractor’s ability to do the work, their working capital, and bank support; ‘capacity’ as their ability to perform a job, which includes their experience, people, and equipment; and ‘character’ as the contractor’s moral or ethical nature and reputation.

In order to gather that information, his agency becomes deeply involved with clients. “We learn the history of their company, their financials, their capabilities, and their failures and successes. We become trusted advisors, like certified public accountants or attorneys, and we have a very high retention rate,” he said.

After the agency gathers all it needs from the person or company, employees analyze and review the material. When that is complete, Phillips determines which bonding company will best serve the client’s needs. “We have the experience to see that the client is placed with the bonding company that matches up best with their type of construction, size, program, and financial position,” he said.

The final step involves submitting a recommendation and the required documents to the chosen bonding company and working out a program for the client. Phillips has access to most of the top 25 surety companies in the country and also offers complimentary products such as builders’ risk, railroad protective coverage, pollution liability, and more.

Projects for which Phillips Insurance recently executed bonds include:

• An $11 million bond guaranteeing the reconstruction of the William F. Davitt Memorial Bridge in Chicopee on behalf of the Mass. Department of Transportation;
• A $10 million bond for the Central Campus infrastructure project at UMass Amherst;
• A $35 million bond for a state utility company for an infrastructure project;
• An $11 million bond written for the masonry portion of the $100 million Commonwealth Honors College Complex at UMass Amherst; and
• A $12 million bond written for a HUD housing project in Greenfield.

Phillips has also written bonds for clients on projects nationwide. They include various clients at the $10 billion Global Foundries project in Malta, N.Y., as well the granite contractor at the Cosmopolitan in Las Vegas.

“We’ve bonded projects from $100,000 to $50 million, and have written bonds for subdivisions, landfills, and solar projects,” he said.

And new work is expected after a license to build a casino in Western Mass is issued, as widely expected. “We’re excited about it. It will be a $500 million-plus project, and if the owner decides to protect the project by bonding the contractors working on it, we will benefit,” said Phillips. “We’ve also seen a lot of activity in solar-field construction, which we expect to be a big part of our bond writing over the next three years.”

Promising Outlook

The Phillips agency’s business in surety bond premiums increased by 30% last year from the year before, and it continues to acquire new accounts.

Phillips wants to expand across the nation, and to that end, he is creating a new website — mybonddept.com — to help agencies that lack the expertise to serve clients who need bonds. “We want to split the commission without taking the business away from them.”

He acknowledges that bonding is a rigorous underwriting process and says an annual review is important. “But I tell new clients to hang in there, because once you accomplish this, you have an unlimited ability to work. It opens up so many doors.”

Are You Protected Against Cyber Theft?

By BusinessWest Staff February 25, 2014

Insurance Sections

If the Answer Is ‘No,’ the Consequences Could Be Costly

By MICHAEL LEVIN

When it comes to cyber security and data breaches, no system is infallible. Some of the largest companies in the world have been victims of data breaches. Recently, the Swansea, Mass. Police Department contracted the CrytoLocker computer virus, and paid ransom to gain access to their files.

While large breaches like those at Target, Neiman Marcus, and Yahoo! receive great media attention, smaller breaches occur daily without much fanfare. A common misconception is that malicious hackers target only large companies. However, small and mid-sized companies are often perceived — for good reasons — as easier targets due to their limited IT resources.

What is the incentive for criminals to steal data? There is a large black market for stolen identities. Some estimates put the value of stolen personal identifiable information (PII) and personal health information (PHI) at $5-$10 per record, depending on the information. Malicious hackers who gain access to computer systems have the potential to modify accounts-payable data and change bank routing numbers.

Human Error

Another common misconception is that most breaches result from a hacker sitting behind a computer in some foreign country. Malicious hacker activity has and will continue to occur; however, some studies estimate that approximately 50% to 60% of breaches result from simple human and system errors.

For example, unencrypted laptops and smartphones that are lost or stolen pose a large threat, as do data backups brought home by an employee for off-site storage. Lost or weak passwords continue to be an issue as well. It’s fairly common to see a sticky note on an employee’s computer monitor with their username and password to access the enterprise software system (hopefully not the controller).

In addition, people often mistakenly send e-mails to someone other than the intended recipient. How many times have you replied to an e-mail that started with, “I think you meant to send this to another person?” If the e-mail contains PII or PHI, this may be a breach.

Not understanding the technology in your office can also result in a breach. Affinity Health Plan Inc. settled with the U.S. Department of Health and Human Services (HHS) for $1.2 million when it returned leased photocopiers with 344,579 personal health-information records on the copier’s hard drives (yes, modern copiers have hard drives that store data).

Human error breaches are not limited to digital data. Improper disposal of documents that contained PII or PHI has led to breaches. The list of exposures on the human-error side alone is limited only by one’s imagination.

Cyber Risk Management

Implementing preventative measures, best practices, and a strong backup solution help reduce, but not eliminate, the risk. An incidence-response plan that details responsibilities and vendors is crucial to quickly address a breach and to avoid panic buying. Many state laws have time deadlines for certain actions. The clock is ticking once a breach has been identified. A written policy and plan detailing security measures will be of assistance should you be interviewed by the Office of Civil Rights, HHS, or the state attorney general.

Potential Cost of a Cyber Incident

Expenses from a data breach or a cyber incident vary and can be quite high. Beyond the intangible cost associated with the loss of consumer confidence, organizations may face lawsuits, regulatory expenses, regulatory-defense costs, notification costs, and business-interruption losses.

In order to limit the damage, organizations often hire public-relations firms, outsource call centers, provide credit monitoring for at least a year (required by law in some states), and provide identity-fraud insurance.

Forensic specialists may be required to identify and remediate the source of a breach that results from an organization’s computer systems. Again, the clock is ticking. Not finding and resolving all the issues with a system creates further exposure down the road.

As discussed earlier, part of a comprehensive cyber risk-management program is to have a good backup solution and to monitor it regularly to ensure that data is consistently backed up. Without a solid backup strategy, organizations may incur data-restoration and computer-program-restoration expenses — assuming the data and programs can be restored.

Cyber-liability Insurance

It is important to understand that a general-liability insurance policy typically does not respond to cyber exposures. Available cyber-liability insurance coverages include network and information-security liability, security-breach remediation and notification, hacker damage, crisis-management expenses, business interruption, cyber extortion, media, data restoration, and computer fraud.

Today’s cyber-insurance policies are flexible so that you can choose coverages based on your unique needs, exposures, and risk tolerance. Developing a meaningful cyber-insurance program requires an understanding of an organization’s IT systems, data-security best practices, and level of employee education.

In Summary

Whether or not they realize it, most organizations, no matter the size, have some sort of cyber-security or data-breach exposure. If you store personal identifiable information or personal health information, your risks increase exponentially. And these risks are here to stay.

There are far too many cyber-security exposures to be covered in a single article. It is important to work with an insurance agent who is capable of understanding your exposures and who can match insurance coverages and carriers to meet your unique needs. A properly structured cyber-liability insurance policy can be an important element to an organization’s overall cyber-risk-management program and long-term sustainability. n

Michael Levin is an account executive at the Dowd Insurance Agency, a full-service agency providing personal, commercial, and financial-planning needs, with six offices in Western Mass.; (413) 538-7444; [email protected]

Protect and Serve

By BusinessWest Staff February 25, 2014

Insurance Sections

A chart of insurance agencies in the region

Click here to download the PDF

Weather Patterns

By BusinessWest Staff December 17, 2013

Insurance Sections

Severe Storms Are Creating a Trickle-down Effect on Policy Holders

With past and future storm damage in mind, Jim Phaneuf says, the state attorney general and insurance commissioner are making sure that carrier premiums and rate increases are justified.

When Jim Phaneuf references the weather, he’s certainly not making small talk.
Rather, he’s discussing big business — the insurance business, which he’s been in for more than 36 years, enough time to see everything, or just about everything, in this industry.
Indeed, over the past several years — and one year in particular, 2011 — Phaneuf, president of Bell & Hudson Insurance Agency in Belchertown, and others in this sector have seen things they’ve never seen before in terms of weather calamities and the resulting impact on the companies that write the policies and the consumers who purchase them.
‘Historic’ is the word he and others have used to describe it all — meaning everything from 2011’s ice dams, tornadoes, hurricane, and freak October snowstorm to subsequent weather events such as Superstorm Sandy in the fall of 2012, and the general consensus that this part of the country will see more of the same in the years to come.
But instead of words, Phaneuf and others like to use numbers to get their points across.
“Between 1980 and 2012, there were 123 U.S. weather-related events that resulted in claims of over $1 billion,” he told BusinessWest. “In 2011 alone, there were 12 U.S. weather-related disasters with over $1 billion in claims, and that caused insurance companies to raise rates to attempt to recover their losses. Our experience has been that most home-insurance customers have experienced rate increases in the past two years, largely as a result of the storms of 2011 and 2012.”
Corey Murphy, president of First American Insurance Agency in Chicopee, agreed, noting that 2011 was a banner year for weather-related claims in this region and others, and the impact from those losses will be felt for some time.
“I knew the insurance companies were going to have to respond — it was a catastrophic year; we had pretty much every natural disaster you could have,” he said, noting that rates have escalated for business and residential policy holders alike, between 3% and 6% on average.
The numbers vary, he said, because in many instances, an agency can sometimes shop for and get a better price, even at a time when many carriers are still struggling to recover losses. Meanwhile, agents can work with clients to lower their insurance bills by making sure they’re buying only what they need, passing on what they don’t need, and employing strategies such as bundling policies, taking higher deductibles, and avoiding marginal claims that will nonetheless trigger premium hikes.

Corey Murphy and his staff have kept their commercial and residential rate increases from storm damage as low as possible by shopping their policy needs with a variety of carriers.

Overall, he said, this is a time for consumers to renew — and tighten — their relationship with their insurance agency, because if predicting the weather is difficult, if not impossible, so too is gauging and minimizing the impact of all that weather on one’s insurance bills.
For this issue and its focus on insurance, BusinessWest takes an in-depth look at what has become a perfect storm — in every aspect of that phrase — for insurance carriers, and a time of challenge for those looking to protect their assets and manage the cost of doing so.

Climate Change
Recapping recent events, meaning those of the past few decades and especially the past few years, those we spoke with said things have become more unsettled.
They used that word to refer to both the weather — which, in the opinion of many, is being increasingly impacted by global warming — and the fiscal health and well-being of insurance carriers.
Indeed, due to the recent spate of weather calamities, most insurance companies will not write polices for hurricane-prone coastal properties in the Carolinas, Georgia, Florida, and Texas, said Bill Grinnell, president of Webber & Grinnell Insurance Agency in Northampton. So the states have created their own insurance mechanisms and set up rules, collecting premiums from property owners and assessing surcharges to those insurance companies that do business in other regions of those states.
“There is a wide belief that these storms are caused by global warming, which makes the weather less predictable and insurance outcomes less predictable,” Grinnell explained. “As a result, more revenues are needed to create reserves to cover the potential for more disasters, so there’s definitely been an uptick in the cost of insurance.”
According to a 2013 report, “Inaction on Climate Change: the Cost to Taxpayers,” by Ceres, a nonprofit organization advocating for sustainability leadership, the total loss exposure of these state-run insurance plans in the past 20 years has risen by 1,550%, from about $40 billion in 1990 to more than $600 billion in 2010. Additionally, the report says only 50% of the damages in the U.S. caused by extreme weather events are privately insured, which leaves the federal and state governments (the taxpayers) to pick up the remaining tab.
Insurance companies, said Grinnell, earn revenue in two ways: premiums, of course, and conservative, low-risk investments, primarily in the bond markets.
With the historically low rates of return on bonds, insurance companies are not earning as much as they have in the past, and at the same time, they’re seeing higher bills from their reinsurance companies after paying out billions for just the past two years’ worth of catastrophic storms.
“So the reinsurance companies that provide the insurance for your insurance carrier for big disasters have increased their rates to the carriers, and those rates have been passed right down to the policyholders,” Grinnell explained, adding that the regional carriers in New England that do business in Massachusetts weren’t directly affected by Hurricane Katrina or, to a great degree, Superstorm Sandy. “So the majority of the storm-related increases are due to more localized events.”
Locally, Phaneuf added, state Attorney General Martha Coakley and Commissioner of Insurance Joseph Murphy are making sure carrier premiums and rates are justified.
“The attorney general seems to have served as a watchdog with the insurance issue,” he said, “to keep insurance companies’ rising rates in check.”

Policy Statement

Bill Grinnell says insurance carriers are getting hit with higher rates from their reinsurance companies and passing these increases down to policyholders.

In this changing climate — for both weather and insurance to cover the damage it causes — Grinnell said agencies need to work even more closely with clients to reduce the impact on premiums while making sure customers’ bases are covered, literally and figuratively.
For instance, when his staff sees a client’s premiums spike significantly, they will attempt to shop that business around to get similar coverage, but at a better rate.
“We try to find a better home for their insurance if we’re able to, which we can some of the time, but not all of the time,” he said. “It’s definitely worth the effort if the insurance is going up more than 7% or 8%.”
Murphy agreed, but noted that there is seemingly less room for negotiating between agency and carrier in this environment, adding that this is another sign of the times and a product of the more adverse conditions within the industry, even though the weather has been much calmer this year.
“There’s a lot less back-and-forth over the last year or two. Now, there’s a lot less room; they’re pretty firm on what their prices are,” he said. “This year, it was a pretty mild year, but there were predictions that storms would increase, so there were a lot of adjustments by carriers based upon that.”
Those adjustments, Murphy went on, have appeared as higher premiums and a much harder look at what policies companies will underwrite. He called it “getting tighter.”
When Murphy and his agents present a potential policyholder to an underwriter — the person at the carrier who will decide how much to charge on the commercial lines, or even if they’ll write it or not — they want a much clearer picture of what they are writing.
“So, as an agent, we’re trying to present the best possible picture of that potential client,” he added. “The more you can make an underwriter feel comfortable about what they are writing, the better they feel about doing it.”
Meanwhile, agents can work with clients in a number of ways to help control their insurance bills without reducing coverage, said Phaneuf, listing several possible ones, including a willingness to accept a higher deductible.
“They generally mean lower annual premiums, but more out of your pocket when you have a loss,” he explained. “Your agent will also make you aware that you can control premiums by bundling discounts for your home and auto and installation of alarm systems, renewing your policies with the same insurer, and maintaining a loss-free status.”
Elaborating, he said that going years without filing a claim can lead to attractive discounts, savings that could more than offset the long-term costs from filing a claim in an instance where the damage only marginally exceeds the deductible.
In addition, Murphy told BusinessWest, he and his agents make sure their business clients are updating their product inventory and specific elements that they need for doing business.
“Business owners have to understand what their business is rated on,” he noted, adding that some standard ratings are based on square footage, which doesn’t change unless there is an expansion or a move, but other things do change, like real-estate values, replacement costs, inventory levels (up or down), or an increase in sales, all of which accurately reflect the business’s exposure.
The First American staff helps educate their commercial clients about keeping up with the current state of their property and business.
“If you don’t respond to your carrier with any updates, then they assume that all remains the same, and you could be paying more when you shouldn’t have to,” said Murphy. “But you don’t want them to be caught underinsured.”

Batten Down the Hatches
Grinnell and others we spoke with said their background is in business and insurance, not climatology or meteorology.
Predicting the weather is more difficult than ever, he noted, adding that even those with degrees in those subjects can’t say what will happen next year or over the next decade. The best thing to do is be prepared as much as possible, and that philosophy extends to the realm of insurance.
Phaneuf agreed, adding that, when it comes to weather patterns that are predicted to cause havoc in the future, protection of one’s home or business is, now more than ever, a complex business transaction.
“It cannot be effectively and appropriately done in 15 minutes,” he said. “In spite of what some national insurance carriers would like to have you believe, it is not a simple transaction like buying laundry detergent or breakfast cereal. If you treat it too lightly, you may not have the protection that you need when you need it … at a time of great loss.”

Elizabeth Taras can be reached at [email protected]

Process Engineering

By BusinessWest Staff December 17, 2013

Insurance Sections

How to Reduce Stress and Optimize Outcomes in Filing Insurance Claims

John E. Dowd Jr.

Let’s begin with the premise that insurance companies are in the business of paying claims, pure and simple. However, as most people are aware, the process of filing and then being paid for compensable claims is not always easy or convenient, depending on the size and nature of a claim.
We try to advise our clients at the outset of every claim of the appropriate steps they need to take to make sure things go as smoothly and quickly as reasonably possible. We also try to carefully manage people’s expectations for how the claim process will go, as well as the eventual payout amount they can expect. Unfortunately, some insurance companies handle claims better than others, and you need to rely on your insurance agent/broker to properly represent you both at the time you choose your insurance company and when a claim has occurred.
Many of the complaints insurance companies receive each year are from customers who are unhappy about claims handling. For many years, one of the top complaints people have regarding the claims process is a delay. When people are dealing with the issues that made them file a claim, it can be frustrating to handle the insurance claim on top of that. For this reason, it is important for all policyholders to be prepared. One of the best ways to do this is to make sure all of the information the insurance company would need is always available.
Policyholders should keep this information in a safe place where it will not be lost or forgotten. The following suggestions are also helpful.
• When filing claims, make sure they are submitted promptly. Call your agent/broker immediately after something happens that warrants a claim. Letting receipts pile up can cause more delays. If temporary repairs are put off or are not completed, the initial damage to the home could worsen. For example, water damage that is not addressed promptly could lead to problems that cost more money and may create coverage issues.
• Understand the policy. It is important for every individual to know what his or her policy says. Knowing what is covered and what is not covered makes it much easier to know what to expect when damage occurs. Waiting until a disaster happens to read through the policy will only result in further frustration. Talk with your agent/broker ahead of time so he or she can explain your coverage and answer questions.
• Use correct and complete information for the claim. Using incorrect or incomplete information will result in processing delays. Check all of the information for accuracy twice before submitting it, and make sure everything that is required has been provided.
• Keep records of all forms of correspondence. When making calls, sending e-mails, or receiving letters, make sure each one is recorded. Write down the date, the form of correspondence, the name of the contact person, and the subject of the correspondence. If there are any important details, include these in the notes. Policyholders should always ask questions and address any disagreements promptly.
• Keep records of temporary repairs. Some types of damage warrant immediate but temporary repairs. If this is the case, it is important to document any work that was done and who completed it. When purchasing supplies or services, save the receipts. Taking photos or videos before and after the repairs is also helpful. Homeowners should never make permanent repairs. Policies cover only necessary temporary repairs. Those who want to know how much it will cost to complete permanent repairs should arrange for one or more adjusters to provide quotes.
• Verify any denials. If a claim is denied, politely ask for the language in the policy that reflects why it was denied. Your agent/broker will assist you in confirming the accuracy of the coverage denial.
• Never rush into a settlement. When a settlement offer does not seem fair, contact your agent/broker immediately to discuss the matter.
• Ask for information to be released for health claims. If medical help was needed due to the reason for the claim, it is important to ask a medical provider to release relevant information. When policy holders suspect that a medical provider is overcharging, an insurance company may audit the bill upon request.
The claims process is a stressful one for many people. With proper preparation, this stress can be reduced significantly. The most important thing to remember is that your agent/broker is always available to help during any part of the process, so do not hesitate to contact your agency when questions arise.

John E. Dowd Jr. is a fourth-generation principal of the Dowd Agencies. He is one of three partners at the oldest insurance agency in Massachusetts with operations and management under continuous family ownership. The Dowd Agencies is a full-service firm providing personal, commercial, and financial-planning needs, with four offices in Western Mass.; (413) 538-7444; [email protected]

Know the Rules of the Game

By BusinessWest Staff December 17, 2013

Insurance Sections

Leverage Your ‘Mod’ Squad to Keep Workers’ Comp Costs Down

By BILL GRINNELL

When Red Sox pitcher John Lackey grabbed his right arm in pain and walked off the mound in his first game of the 2013 baseball season, I can imagine that the Red Sox management held their breath. He had missed all of the 2012 season. They had just invested a year in getting Lackey healthy, including costly surgery and extensive rehabilitation.
During that year, Red Sox management diligently followed Lackey’s progress. They encouraged his return as soon as possible. And, after learning that his pain that day was just a bicep strain, they had him up and throwing again 10 days later. He was back in the rotation to beat the Houston Astros just three weeks after the strain.
If you have an employee on your company’s disabled list, you would do well to follow the Red Sox management’s example.
Sidelined employees are not only a drain on productivity, but they can also quickly escalate your workers’ compensation costs. Keeping tabs on these employees’ healing process and getting them back to work as soon as possible are key to reining in those costs.
The factors that drive workers’ compensation costs are many and complex. Understanding them is important. You can’t manage what you don’t know.
Generally speaking, workers’ compensation policyholders with an insurance premium over $5,000 are subject to the Mass. Workers’ Compensation Bureau experience-modification rules. These rules establish an experience-modification factor (or ‘experience mod’) that is used to calculate your workers’ compensation insurance premium.
Like auto-insurance rates, experience mods are designed to make premiums cost more for those insureds with adverse loss experience and reward those with better-than-average experience.
The formula for your experience mod takes into account the frequency and severity of your losses compared with similar-sized companies in your industry. The bureau uses policy-holder loss data that is reported by insurers every year to calculate the experience mod.
The bureau looks at a three-year period of losses to minimize the effect of an extreme year (good or bad). The three-year period covers the three years prior to the last policy year completed. For example, an experience mod calculated on Jan. 1, 2014 will take into account the data from the policy years Jan. 1, 2010 to Jan. 1, 2011; Jan. 1, 2011 to Jan. 1, 2012; and Jan. 1, 2012 to Jan. 1, 2013.
A ‘snapshot’ of the losses is taken six months into a policy term and then reported. It’s important to attempt to close out open claims or question high reserves prior to this six-month snapshot event.

How It Works
Let’s talk about how the experience mod works and then get to how you can control your workers’ compensation premiums.
Remember how I said that the experience mod takes your frequency and severity of losses and compares them to what would be expected of a company of your size in your industry?
Well, if your actual losses are lower than expected, your experience mod will be less than 1.0, yielding a credit factor. The credit factor is applied against the standard premium and will save you money.
If your actual losses are greater than expected, then your experience mod will be more than 1.0, generating a debit factor. The standard premium would then be multiplied by the computed debit.
In Massachusetts, it is important to understand the dramatic impact that small losses can have on an experience-mod calculation. The full brunt of a loss up to $5,000 is added into the equation. The amount of a loss above $5,000 is discounted by factors near 80%. Two $5,000 losses produce a significantly higher debit than one $10,000 loss.
Experience-mod calculations are more sensitive to adverse loss experience today than ever before. While our elected officials can claim that Massachusetts has some of the lowest workers’ compensation rates in the country, you won’t hear them talking about mod calculations. Favorable rates have been significantly offset by experience-mod surcharges.
Loss-control programs, safety manuals, and light-duty return-to-work plans are all important ingredients toward achieving a lower mod. Tactics like these and others can be your ‘mod squad’ and help you keep workers’ compensation premiums down.
But most important of all, be careful who you hire. New hires have consistently been the source of the worst workers’ compensation claims. Your hiring process is the key to your workers’ compensation experience-mod success.
With a selective hiring process, diligence with employee safety, and support to get injured and ill workers back on the job, you can keep your experience mod in check — and hopefully get World Series-winning performance from your employees!

Bill Grinnell is president of Northampton-based Webber and Grinnell Insurance Agency; [email protected]

What’s Your Policy?

By BusinessWest Staff December 17, 2013

Insurance Sections

A chart of area insurance agencies

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Hacking It

By BusinessWest Staff June 18, 2013

Insurance Sections

Cyber Liability Is the Hot Trend in Business Insurance

Even one electronic security breach is a headache for businesses that store their customers’ financial records. Millions of thefts? That’s much worse.
“They’re like mosquitoes,” said William Trudeau, president of the Insurance Center of New England in Agawam. “It’s one of those things where one or two bites isn’t too bad, with five bites, you’ve got an itch, but if you have 5,000 bites, you might die. For a small bank, if someone steals 100 ATM cards, it’s going to be not fun. But if, all of a sudden, they steal the records of 20,000 ATM cards and are withdrawing money all over the world for two days, it could get ugly.”
It’s not just banks that worry about such breaches. Large retailers, which keep the credit-card records of their customers on file, are at risk as well, as the TJ Maxx incident that came to light six years ago.
In that case, hackers gained access to company databases in 2005 and stole the personal information of more than 45 million credit and debit cards — but the company didn’t discover the theft until two years later. TJ Maxx later claimed that 75% of the cards were either expired at the time of the breach, or the personal information on them was masked. But the international ring of thieves did use much of the data to enrich themselves before they were arrested — and the various consequences of the incident eventually cost the clothing chain more than $130 million.
“After the TJ Maxx incident, Massachusetts law mandated self-reporting and potential fines per incident,” Trudeau said, but the costs stemming from such a breach can range widely, from PR work to restore brand reputation to individual and class-action lawsuits.

Bill Trudeau says companies victimized by hackers can run up massive expenses even before customer lawsuits arrive.

“Say a company wants to rectify things, says that it won’t happen again,” he continued. “So they pay for two years of ID theft protection for anyone who wants it. Then you need to do notification by third-party certified mail to all customers. Say I’ve got 30,000 records, so I’ve got to send out 30,000 pieces of mail from a certified facility, costing maybe $90,000. Then, how many will take me up on two years of identity-theft protection? Maybe 10%?
“What you have here are first-party costs,” he went on. “It’s not someone saying, ‘OK, I lost 20 grand, and now I’m suing you.’ You’ve got a lawyer in your office saying you need to do certain things now, even though there’s no lawsuit yet. But who’s going to pay the $90,000 for mailings? Who’s going to pay for the ID-theft protection? There’s a huge potential for loss, even before the lawsuits arrive.”
As a result, cyber liability is one of the hottest terms in the insurance world, one that agents have been busy telling their clients about.
“We’ve been concentrating on this kind of insurance,” said Robert Gilbert, president of the Dowd Insurance Agencies in Holyoke. “I read four trade publications each week, and every single one, every week for the past year, has had an article about what we call cyber-liability insurance. That includes Internet liability, cyber-security … anything that can attack your computer and cause loss of data.”
And businesses make a mistake if they assume that large, national retailers are the only ones at risk. Verizon issued a report on data-breach investigations last year that analyzed data from 855 reported incidents that resulted in 174 million compromised records in 2011. That study revealed that 71% of breaches struck organizations with fewer than 100 employees.

Bob Gilbert says his agency has been busy informing business-insurance clients of the need for cyber-liability coverage.

As a result, Gilbert said his agency has been busy notifying its clients about cyber threats and the insurance products available to protect them, noting that banks, retailers, restaurants, and medical businesses are among those with the most potential threat exposure. “We’re talking about businesses where customers are using credit cards. That data is capturable. Large retailers are constantly taking credit cards because that’s how most people pay for things. So it’s significant.”

Growing Concern
Earlier this spring, Best’s Review cited several recent surveys that shed light on the extent of the cybercrime problem and how it concerns businesses. For instance, a survey by American International Group found that corporate executives are more concerned about cyberthreats than any other major business risk, with 85% of the 258 surveyed saying they are ‘very’ or ‘somewhat’ concerned about it.
Meanwhile, a Deloitte Tech Trends poll of 1,749 business professionals found that 28% of those surveyed reported at least one known cyberattack in the past year; 9% reported more than one breach. And those are just the known cases.
According to the Ponemon Institute, which has been reporting on the cost of cybercrimes for the past three years, the average cost to a company from data theft is $194 per record breached — meaning it takes just 515 such records stolen to reach a six-figure loss, a tough pill to swallow for small to mid-sized companies.
That’s why cyber-liability insurance is so important. Trudeau cited one product his company promotes, Beazley Breach Response, which covers many of the first-wave expenses of cybercrime, including notification and credit-monitoring services for up to 5 million affected individuals, as well as forensic and legal assistance, PR costs, and other benefits, with separate coverage limits for third-party claims.
“Many policies offer first-party coverage — that is, they will pay you for things like business interruption, the cost of notifying customers of a breach, and even the expense of hiring a public-relations firm to repair any damage done to your image as a result of a cyber attack,” business-technology writer Minda Zetlin noted recently in Inc. magazine. “Having this cash available in the event of a crippling hack can keep the lights on until you’re able to resume your normal cash flow. A good policy can even cover any regulatory fines or penalties you might incur because of a data breach.”
Early response, aided by such coverage, can be critical, Trudeau said. “Depending on how good the response is, you don’t always get to the liability point if you self-report that you’ve had a breach.”
Considering the rate at which businesses are attacked and hacked, Gilbert said, it’s tremendously risky for companies that store sensitive data to ignore their need for cyber-liability coverage.
“When private data has been hacked, the expense to go through it is tremendous — you have notify all the people in the database, there are advertising expenses, possibly litigation,” he explained. “As technology has changed so rapidly, so has the expertise of criminals. The insurance marketplace never anticipated the seriousness of these crimes.”
But it’s certainly paying attention now. “When you’re hacked, and someone has access to everything in your computer, they can throw viruses in there or extort your business with the threat of viruses,” Gilbert added. “There are so many different areas of exposure, so it has become a very big issue.”
Customer notification alone can be a major hassle, considering that 46 of the 50 U.S. states have notification laws, the details of which vary by state — and many breaches affect customers in multiple states. “You should talk to your risk manager or agent,” Gilbert tells clients. “Do you have this coverage? What do you need to secure it? If nothing else, we make them aware of the exposures they face.
“It definitely interrupts your business. You have a loss of income, a loss of profits,” he added. “We talk to clients about what their exposures are today and what to do about it.”

Constant Threats
In a world where data theft is pervasive — from restaurant waiters carrying ‘skimmers’ in their pockets to lift debit-card information to international hackers hammering their way into large corporations — companies increasingly realize that it’s up to them to both better secure their data and seek out a realistic level of coverage, Trudeau said.
“When doing an assessment, ask, what’s the exposure risk? What exposures do we have, and how could we get in trouble?” he said, re-emphasizing that those risks run from the debit-card information stored at Big Y to the HIPAA-protected patient data at medical practices.
“It doesn’t matter if you’re a big company or a small company,” Kelly Bissell, who heads Deloitte’s Information Technology Risk Management Team, told Best’s Review. “It matters what data you have that’s valuable to them. The bad guys don’t discriminate.”
It’s also dangerous for businesses to assume they’re protected against data breaches of third-party vendors, experts say, since they provided them that information in the first place. Nor is there any guarantee a cloud provider will cover a company against a data breach in the cloud. It all comes back to speaking with an insurance agent to make sure all contingencies are accounted for.
“Every time you open the paper, another bank has gotten hacked,” Gilbert said. “Criminals today are pretty smart. They’re not using guns and knives anymore; they’re sitting somewhere in Russia or somewhere in Oklahoma — it doesn’t matter where.”
And that changing world has forced changes in the insurance realm, with the advent of products that are becoming an increasingly necessary part of companies’ risk-management strategies.
“This type of coverage has been developed to meet a need,” Gilbert said. “With what’s going on with cybercriminals, it’s very important that, every account we go out on, we’re bringing up things they don’t have. That way, at least we’ve done our job.”

Joseph Bednar can be reached at [email protected]

Covering Your Bases

By BusinessWest Staff June 18, 2013

Insurance Sections

Understanding the Many Nuances of the Affordable Care Act

By MARC A. CRISCITELLI
The Affordable Care Act (ACA), commonly known as Obamacare, will help some people, but has definitely created confusion and concern for most.
There are several approaching deadlines dictated by the ACA that employers must comply with. Some of the deadlines mentioned below have few financial obligations, but require administrative tasks:
• Summaries of benefits and coverages (SBCs) must be distributed to employees for plans that renewed on or after Sept. 23, 2012. Insurance carriers are producing the SBCs for employers, and they must be distributed to employees, new hires, and those continuing on state or federal continuation (COBRA).
• Employers issuing 250 or more W-2s must include the value of health-plan benefits provided to employees on the W-2s annually.
• Employers must provide notice to employees about the availability of state health-insurance exchanges, also known as marketplaces or the Small Business Health Options Program (SHOP), by Oct. 1, 2013. The deadline was formerly March 1, 2013, but it was delayed since the majority of states and the federal government were not ready to administer the health exchanges.
Unfortunately, there are many provisions of the ACA which may carry some significant cost increases directly to employers.
• Effective Jan. 1, 2013, flexible spending accounts must limit the annual contribution maximum to $2,500. This will lower tax savings for uncovered medical, dental, and vision expenses for employees and consequently employers.
• The comparative clinical effectiveness research fees pay directly to the newly created federal institution known as the Patient Centered Outcome Research Institute (PCORI). Employers with plans renewing Oct. 1, 2012 through Jan. 1, 2013 will have to pay $1 per insured person by July 31, 2013. It will increase to $2 per insured person the following year and will be indexed in years 3-8. Insurance carriers pay the fee on behalf of fully insured employers. Those employers that offer a healthcare reimbursement account (HRA), are self-insured, and/or fund at least $500 into their employees’ flexible spending accounts must file IRS Form 720 and pay the PCORI.
• All employers will be required to contribute to a transition reinsurance fund in 2014, 2015, and 2016. The annual fee is per covered life and is likely to equal $5.25 per month per covered life in 2014 and may decline in 2015 and 2016. This fee will be included in the premiums for employers who are fully insured, but self-insured groups will have to pay this fee directly. Reporting will be due in November 2014 and payable 45 days after reporting. Final rules have not been communicated as of yet.
• Employers with 50 or more full-time-equivalent employees must have waiting periods of no more than 90 days and must offer coverage to employees working an average of 30 hours per week starting in 2014. This will be extremely expensive to many employers, especially those in industries that historically did not offer health insurance to their employees.
• Starting in 2014, employers with 50 or more full-time-equivalent employees must offer ‘affordable’ coverage. This means that they cannot charge more than 9.5% of an employee’s income for the single level of coverage and must offer a plan that is considered ‘minimum value’ if the plan’s share of covered charges is at least 60%. If an employer does not offer coverage to 95% of its full-time employees, the penalty is $2,000 per full-time employee per year (excluding the first 30 employees) if one employee receives a premium tax credit though the SHOP exchange. Employers that offer coverage that does not provide minimum value or is not considered affordable will pay a penalty of $3,000 per year for each employee who receives a premium tax credit.
There are some other provisions of the ACA that cause a direct financial impact to employers and all employees that have private insurance.
The expansion of Medicare and Medicaid will be the biggest drivers. The largest contributing factor to the increase in healthcare costs — and, consequently, private health-insurance costs — has been and will continue to be the ever-increasing population of those covered by Medicare and Medicaid.
The economics are simple. Medicare and Medicaid reimbursement rates to healthcare providers are much lower than reimbursement rates from private insurers and HMOs. The more patients seen by a healthcare provider each year who are insured by Medicare or Medicaid, the more the provider needs to charge private insurers to make up for the low payments they receive from the government-funded healthcare plans.
As a final point, I only touched upon some of the negative effects of the ACA, but there are further responsibilities thrust upon employers, both financial and administrative, buried within the more than 2,700 pages of the law. I encourage all employers to contact their broker, consultant, and CPA for guidance to make sure they are prepared for the full effect of the ACA.
Even though there will be people who benefit from healthcare reform, it will be at the detriment of employers having to deal with and pay for the most daunting law passed in decades.

Marc Criscitelli is vice president of East Longmeadow-based FieldEddy Insurance; (413) 233-2134; [email protected]

Do I Really Need Travel Insurance?

By BusinessWest Staff June 18, 2013

Insurance Sections

Because Trips Are Sizeable Investments, the Answer Is Usually ‘Yes’

John E. Dowd Jr.

In many cases, vacations can involve thousands of dollars and months of advanced planning, organizing, and saving. So if you’re wondering if you need travel insurance, the answer is often ‘yes.’
Like any other investment of this magnitude, it’s important to make sure you have adequate insurance to protect yourself should the tour operation or cruise line you’ve booked with go bankrupt, you or a family member become ill, or some other unforeseen event upset your vacation plans.
Travel insurance can be purchased as a packaged plan with several different options, including travel delay, trip cancellation, baggage, accidental death, auto, 24-hour traveler assistance, dental, emergency medical, emergency medical evacuation, and so forth. The five main types of travel insurance — which are trip cancellation, baggage, emergency medical, auto, and accidental death — can each usually be purchased as an individual policy.

Trip Cancellation
This insurance policy protects you should certain factors prevent you from taking the trip. Look to the specific policy to determine what factors will be covered, but most will include circumstances like a tour operator or cruise line going out of business, personal or family illnesses, and the death of a family member. The policy may also reimburse you for any unused portion of your vacation should you become seriously ill or injured once on the trip.
The cost of trip-cancellation insurance is usually equivalent to between 5% and 7% of what the vacation costs, meaning a policy for a $2,500 trip would be around $125-$175. Keep in mind that trip-cancellation insurance isn’t the same as the cancellation wavier your tour operator or cruise line may offer you.
While the waiver is relatively less expensive, at around $40 to $60 dollars, it must be purchased when you book your vacation. These waivers also are usually accompanied by multiple restrictions, such as not covering a cancellation occurring near the date of departure or once the trip has begun. It’s important to remember that a cancellation waiver isn’t insurance and isn’t regulated by any agency, which means it might not be worth the paper it’s printed on if the business goes bankrupt or closes.

Emergency Medical Assistance
Ask your health-insurance carrier what type and degree of coverage you’ll have on a trip to a foreign country. If your health-insurance policy doesn’t cover you at all or leaves you underinsured while visiting a foreign country, then you might consider an emergency-medical-assistance policy to cover any emergency medical assistance that you might need during your vacation following an injury or illness. The policy would cover medical transportation to a hospital capable of treating your illness or injury, foreign hospital stays, and, should you be seriously ill or injured, transportation home.

Baggage and Personal-effects Insurance
This policy covers you should your personal belongings get damaged, stolen, or lost during the vacation. It usually costs about $50 to cover $1,000 worth of personal belongings for a seven-day trip. Depending on if and how much insurance is provided by your trip operator and/or airline, you may or may not need this coverage.
You’ll also want to determine if your homeowner’s or renter’s insurance covers off-premise thefts before you purchase this coverage. You might consider an endorsement or floater to your homeowner’s or renter’s insurance instead of personal-effects coverage if you’re traveling with high-value items like electronic equipment, sports equipment, or jewelry. Such an endorsement to cover a $1,000 necklace for a year would be about $10 to $40.
Additionally, you may want to contact your credit-card company to determine what, if any, travel-related coverage or services they provide.

Auto Coverage
A typical auto-insurance policy covers only your vehicle within U.S. states and territories and Canada. You can check with your auto-insurance carrier to determine how your auto insurance will apply to your vacation destination and mode of transportation — rental or personal vehicle. Should your trip include taking your personal or rented vehicle outside the areas specified in your personal auto-insurance policy, then you’ll need to purchase coverage applicable to your destination through either an insurance agent, car rental agency, or travel agency. Don’t forget to obtain both liability and physical damage if you’ve chosen to rent a car.

Accidental-death Coverage
An accidental-death policy usually isn’t necessary if you already have an appropriate life-insurance plan. Much like a typical accidental-death policy, this policy provides a benefit should the insured party die on the vacation.
As always, thinking ahead and reviewing your insurance protection before a loss occurs is the best advice anyone can offer. Even if you decide to self-insure, at least you have made a conscious decision so that, if something does happen unexpectedly, you will be more mentally prepared to deal with the consequences.

John E. Dowd Jr. is a fourth-generation principal of the Dowd Agencies. He is one of three partners at the oldest insurance agency in Massachusetts with operations and management under continuous family ownership. The Dowd Agencies is a full-service agency providing commercial, personal, and employee benefits. It has four offices in Western Mass.; (413) 538-7444; [email protected]

Springfield’s Big Bet

By BusinessWest Staff June 18, 2013

Insurance Sections

How Would a Casino Impact Downtown Real Estate?

John Williamson says a casino, if approved, will start a chain reaction of tenant relocations and other real-estate activity.

John Williamson says “the stage is being set” for a flurry of real-estate activity in downtown Springfield — all related to an $800 million casino development that might never materialize.
“There’s an interesting dynamic taking place in the central business district of Springfield,” said the president of Williamson Commercial Properties. In the event that MGM Resorts International wins its bid to build a gaming resort just a few blocks south of the downtown towers, “they’re in the process of trying to assemble as much of the property as they can in the project area, which involves getting various properties under contract to purchase.”
Robert Greeley, partner at R.J. Greeley Co., has noticed the same dynamic taking shape. “Still, until a decision is made, however long that takes, there are so many uncertainties that it’s very difficult for people to make decisions,” he noted. “A lot of owners and landlords will hold out, thinking there’s a windfall on its way, but until they know whether the casino is coming or not, it just puts a significant unknown into the equation.”

Bob Greeley says casino proponents tend to gloss over the possible negative impacts of major construction and traffic.

The general consensus among real-estate brokers headquartered in downtown Springfield is that the short-term chess moves — building owners contracting with MGM and current tenants of those buildings scrambling to find other homes for their businesses — has begun in earnest, particularly since city leaders chose to back MGM’s project over the other competing proposal, by Penn National Gaming in the North End.
“We’re anticipating the relocation of some businesses in the project area, and those things are all ongoing,” Williamson said. “There are numerous properties that MGM has under contract; if the casino goes through, it will acquire those properties. There are also a few properties they’ve already purchased. If the casino doesn’t go through, they’ll simply turn around and sell the properties they acquired.”
None of this early movement should come as a surprise, said Evan Plotkin, president of NAI Plotkin, considering the scope and cost of the proposal — neither of which Springfield has encountered before.
“That’s going to impact a lot of things that go on downtown. In the short term, in anticipation of a possible casino, a lot of people are jockeying around, trying to relocate. The goal is to try to keep businesses in the downtown and not have them move out. My sense is that many of the businesses want to stay in the downtown.”
And that perception touches on the bigger real-estate question downtown: what will the long-term impact be if the Gaming Commission grants MGM a casino license early next year, when the voting is slated to take place?
“There’s a positive effect on the commercial market already taking place, and also expanding opportunity out there in the form of speculation,” Williamson said. “I know there are properties that, because of the fact that they may be acquired, have magically increased in value, so there’s a lot of jockeying for position going on.
“If the casino comes to Springfield,” he continued, “it’s going to have a dramatic impact on the commercial market, and especially the commercial office market, because there are several office buildings in the project area that will be razed to make room for the casino. Those tenants have to find alternative quarters, and that means the amount of office space in the market will decline, and vacancy will diminish. That increase in occupancy raises the value of all properties, which benefits the tax base. It’s good old supply and demand.”
Some aren’t convinced, however, that a casino will be an attractive business neighbor, particularly in the short team. Greeley, for one, cited potential impacts on traffic, street closures, and general construction-related bustle for several years to come. “I think most people who have not experienced this scale of project will be freaked out by the kind of traffic impacts this thing has.”
For this issue’s focus on commercial real estate, BusinessWest delves into the pros and cons, both short- and long-term, of the proposed MGM Springfield casino, and why it’s generating both excitement and anxiety for area property owners and tenants alike.

Lease of Their Problems
Springfield is competing with two other proposals — Hard Rock International in West Springfield, and Mohegan Sun in Palmer — for the sole gaming license the state will award in Western Mass. If MGM is successful, Williamson said, commercial vacancy downtown will certainly decline.
“Landlords now sitting on a lot of vacancy have potential to fill varying amounts of that space up. It’s good for the market all around,” he told BusinessWest. “Lease rates in Springfield have been flat or slightly declining for years, moreso in the class B and C market — the class A market is pretty stable and really won’t be impacted as significantly as B and C properties at the present time.”
From a broker’s perspective, he said, the project will generate demand for space, at least within a six- or seven-block radius of the casino. “This has been called the largest economic-development project in the history of Springfield, taking place smack dab in the heart of the central business district. It will really strengthen the class B and C commercial properties downtown.”
One downside, he said, is tenants finding they have to pay more rent than they are currently paying, “but in some cases, the landlord is going to have to buy them out of their leases, if they have long-term leases, because they need the building to be sold free and clear of all tenants. That may offset any increase in rent they’ll have to pay.”
The possibility of a casino has placed many businesses in a tough place, Greeley said — both those interested in moving into the casino zone, and those who might be forced out. “No one wants to sign a long-term lease not knowing what the future is going to be. It’s a problem.”
And if the casino doesn’t come, he added, after all the preliminary scurrying among property owners near the MGM proposal, “a lot of people will be left with stars in their eyes, and it’ll take them awhile to come back down to earth and be realistic about what the market is without a casino.”
As an analogy, he cited a CVS or Walgreens that overpays — say, $1.5 million — for a corner lot. “Now, the owners of the other three corners, who paid $400,000, think they can get a million and a half, but that’s not going to happen just because CVS was willing to pay it. That purchase really distorts the market.”
In the same way, he continued, if the casino era closes in Springfield several months from now, as abruptly as it began, site owners who were hoping for a casino buyout might be left with an inflated sense of how much South End property is actually worth.
But if MGM does win the Western Mass. bid, “you’ll see opportunities for businesses,” Williamson said. “Some stand-alone businesses may be able to replicate what they do inside the casino. It’s really to MGM’s credit that they’re looking at local companies to have a major presence in the casino. Some of the mom-and-pops may find themselves smack dab right in the middle of the most expensive economic-development project to take place in this city.”
Plotkin agreed, citing MGM’s promotion of its ‘inside-out’ casino concept, one that incorporates surrounding businesses in the project.
“The development plan is very outward-focused, and it’s going to incorporate a lot of the other businesses and entertainment venues downtown,” he said. “And I would hope the cultural and entertainment aspects will not only be an attraction regionally for people to come and visit Springfield, but perhaps to live in Springfield.”
Plotkin likes to paint a picture of downtown Springfield as a sort of an “urban theme park,” he explained. “How do you create that? What do you need to incorporate in a downtown to make it welcoming for people to live and work? If you have a catalyst like MGM, a development of that size and scope, it’s natural you’re going to have spinoff businesses, and hopefully that will lead to more development of market-rate housing and subsequent retail — not just retail associated with the casino, but other retail that you would need to provide goods and services to people moving downtown. I think there’s potential for tremendous spinoff.”

In Demand
Of course, that kind of commercial spinoff will require an influx of talented workers, in a variety of fields, Plotkin noted.
“Businesses are looking for a trained workforce, and a lot of us on the sidelines are wondering if there is enough of a trained workforce in the region to satisfy what MGM needs,” he said, adding that Greater Springfield companies will also have to deal with competition from a casino that needs some 2,000 employees and will certainly lure many away from their current jobs. “I think it’s important that businesses see an increased flow of human capital to the area; that’s a critical point for our success as a city.”
Greeley — who was involved in a third Springfield casino proposal, pitched by Ameristar Casinos on Page Boulevard, until that project was withdrawn late last year — remains unconvinced that a South End casino will be the economic-development catalyst many hope it will be.
“If the casino comes, you have all the impacts over three years, at least, for all the construction and disruption that accompanies such a project,” he said. “This will be the largest construction project in the history of Springfield, and if it’s coming, it’s going to take years for the property owners not directly involved with the casino to come to terms with whether or not they’re going to be positively affected.
“I don’t want to be the rain-on-the-parade guy,” Greeley continued, “but I am very skeptical how much positive effect there will be outside the casino-owned facilities. For example, I don’t think the Fort restaurant will benefit. People aren’t going to eat at the Fort, then come to the casino. That’s not the mentality anywhere.”
Plotkin disagrees. “In all my discussions with MGM, we believe they’re an organization that has a great understanding of what the urban landscape should look like. They’re not looking at a casino in a vacuum; they’re looking at the big picture. Frankly, nobody wants to visit a city just to drop into the city casino, and then leave.
“This is an opportunity,” he told BusinessWest, “to make the entire city more welcoming, to shine a light on some other offerings we have as a downtown, which are many, but have been underappreciated by a lot of people.”
Greeley sees it differently. “A lot of people are drinking the Kool-Aid about how impactful this is going to be on development outside the casino footprint,” he said, “but nothing suggests to me that adding a whole bunch of traffic to the South End will be helpful to other businesses than those directly involved in the casino.
“I think this is being sold as a panacea,” he concluded. “That’s how it’s being marketed. But I haven’t seen a building yet where the renderings didn’t look wonderful.”

Joseph Bednar can be reached at [email protected]

Avoid the Damage of Winter

By BusinessWest Staff February 26, 2013

Insurance Sections

10 Simple Steps to Readying a Home and Preventing Calamity

John E. Dowd Jr.

Many disasters caused by winter-weather conditions can be prevented by taking a few simple steps. Although fall is an ideal time to begin to think about and prepare for the cold winter months ahead, you really need to be constantly assessing such things as snow loads on roofs and decks, appropriate foundation drainage as the snow melts and freezes, and, of course, the dreaded ice dams on your roofs and gutters.

Regular homeowner’s policies provide coverage for ice dams, burst pipes, loss from fires, and wind damage from snow or ice. When snow melts, it can cause serious damage to a home. One of the most common causes of catastrophic loss is winter storms. Although wind and hail are the most common causes of insurance claims, freezing and water damage follow close behind.

It’s important for homeowners to carefully review their insurance policies before winter arrives to understand what is covered. It’s crucial to have ample coverage for rebuilding a home and replacing all the belongings in it. It’s also helpful to consider purchasing sewer-backup insurance.

There are several ways to prepare a home for winter and the damage it usually brings. Consider the following tips:

• Clean out all gutters. It’s important to remove all sticks, leaves, and debris. This helps the melting ice and snow flow smoothly. It also prevents ice collecting and forming a dam, which can result in water seeping into the house’s ceilings and walls.

• Keep trees and branches trimmed. When branches hang over houses during the winter, they’re likely to accumulate snow and ice, which may make them break. Branches falling on homes can cause significant amounts of damage. They may also hurt people who enter the property.

• Use gutter guards. These guards are useful for preventing interference of water flow from debris.

• Seal cracks and holes. Caulk all these spaces to ensure that melted snow and wind can’t enter the home.

• Keep steps and handrails safe. It’s important to ensure that steps and banisters are sturdy. If they accumulate snow or ice, they can contribute to serious injuries.

• Use insulation liberally. Homeowners should add extra insulation to basements, attics, and crawl spaces. When heat escapes through the roof, it contributes to ice and snow melting faster. As the moisture melts, re-freezes, and accumulates, it can cause a roof to collapse.

• Maintain a warm temperature. It’s best to keep the thermostat at 65 degrees to prevent pipes from freezing. The temperature in the walls is always colder than the temperature in the house.

• Call the professionals. The heating system should be checked and serviced every year to prevent fires. It’s also important to ensure that smoke alarms are working. Carbon-monoxide detectors are another valuable safety feature that should be placed in every home. In addition to this, homeowners should have a contractor evaluate the home for structural damage. It’s best to identify and repair minor problems before they become a disaster.

• Be familiar with shutting off the water. Homeowners should know how to do this, and they should know where their pipes are located. When pipes freeze, it’s imperative to act quickly. When going away for an extended time, it’s best to have someone look after the home or have a service professional drain the system.

• Add an emergency pressure-release valve. By adding this to a current system, homeowners will have a system that is protected against increasing pressure from frozen pipes.

Although many of these suggestions appear to be common sense, we all have a tendency to put off certain mundane routine maintenance. As we have all experienced at one on time or another, failure to follow these preventative steps can lead to expensive and annoying problems.

Taking a moment to save the list of suggestions above and use it as your personal fall preventive checklist will save you time and money and give you peace of mind to enjoy the winter season while living in New England.

John Dowd is a principal and executive vice president of the Dowd Agencies, the oldest insurance agency in Massachusetts with operations and management under continuous family ownership. Today the fourth generation of Dowds provides counsel and coverage from several offices in Western Mass.: James J. Dowd & Sons Insurance Agency Inc. of Holyoke; Cray-Dowd Insurance Agency Inc. of Hadley; Moskal Dowd Insurance Inc. of Indian Orchard; Dumont-Dowd Insurance Agency Inc. of Southampton; and Dowd Financial Services LLC in Holyoke; www.dowd.com.

Seeking Protection

By BusinessWest Staff February 26, 2013

Insurance Sections

A chart of area insurance agencies

Click here to download the PDF

Safety Net

By BusinessWest Staff November 6, 2012

Insurance Sections

Voluntary Benefits Are Becoming More Popular with Employees

Patti D’Amaddio says employees, especially those in Gen X and Gen Y, embrace voluntary benefits, even though they pay much of the costs.

By definition, an employee benefit is a perk largely paid for by the employer.

Right?

Actually, that’s not always the case these days, as a concept called ‘voluntary benefits’ is becoming increasingly prominent in workplaces across America. These are benefits made accessible to employees but are paid for mostly or fully out of their own pockets.

And workers, for the most part, are responding positively.

“The voluntary benefit is really an increasing trend, no question,” said Patti D’Amaddio, human resource generalist at the Employers Assoc. of the NorthEast, “because it allows the employer to add value to their benefit plan without adding a lot of cost. Instead of not offering things they feel they can’t afford, they’re offering voluntary benefits and letting people tailor them to match their personal needs, whether it’s long-term care or a number of other things.”

A survey conducted by EANE registered growing use of voluntary benefits, or VBs. Of the member companies that responded, 62% of them offer VBs of some kind. Of this group, 93% offer supplemental life insurance, 70% offer dependent life insurance, 20% offer auto insurance, 18% include long-term-care insurance, and 10% provide legal services. Four percent even offer pet insurance.

“That’s valued especially by Baby Boomers, whose kids have grown up; they’re spending a lot of money on their pets,” D’Amaddio said. “Again, anything can be tailored to the employees’ needs. Even if it costs the employee, it’s seen as a benefit being offered by the employer to the employee.”

Jim Mooradian and Bryan Lambert, founder and broker, respectively, with Jim Mooradian and Associates, a Boston-based insurance-brokerage firm, recently wrote on the topic of voluntary benefits for the Northeast Human Resources Assoc.

They note that, in today’s changing financial landscape, companies are looking for creative ways to expand their benefits packages while tightening their belts in other ways. In many cases, businesses are looking to control costs in their medical plans and other employer-funded benefits, from gym memberships to eye care.

Scott Llewellyn, western regional sales vice president at the Ameritas Group, recently told California Broker magazine that the idea of spending a few dollars per paycheck for that peace of mind is appealing to many employees — especially at a time when employers are paring back the health and dental benefits they traditionally pay for.

“Offsetting some of the lack in demand created by the down economy is a host of very new and creative voluntary benefits,” he notes. “Brokers are using these benefits to help increase their income, given the new realities of lower commissions from medical carriers.”

As Mooradian and Lambert point out, “companies increasingly see voluntary benefits as an effective tool for boosting employee commitment at little to no cost. Since voluntary benefits are employee-paid, corporate expenses are minimal, yet VBs deliver an immediate, tangible benefit to employees. Once the benefit is set up, there are virtually no ongoing demands on HR staff resources, since claims are administered directly by the carrier.”

It’s a win-win, but only if employees feel voluntary benefits are worth the expense. Increasingly, they do.

Youth Appeal

D’Amaddio cited a MetLife study that suggested that younger workers — both Gen X and Gen Y — are driving the new interest in voluntary benefits.

According to the survey, one half of such workers in smaller businesses (those with fewer than 500 employees) said current economic conditions make them look more toward employee benefits to achieve financial security — even if they have to fund 100% of the cost themselves.

Timm Marini says chronic disease coverage, such as cancer insurance, is one of the hottest trends in voluntary benefits.

Businesses, in turn, are seeing voluntary benefits as a recruiting and retention tool. Four out of five employers of smaller businesses surveyed in MetLife’s 10th annual Study of Employment Benefit Trends ‘strongly agree’ that retaining quality workers is an extremely important objective of employee benefits. Meanwhile, the survey found that 72% younger workers who are very satisfied with their benefits feel a strong sense of loyalty to their employers, compared with 46% of younger workers overall.

“It’s hard to overestimate the importance of responding to the needs of younger workers on whose shoulders the future of a small business can depend,” said Anthony Nugent, executive vice president of Group, Voluntary, and Worksite Sales at MetLife. “Our study underscores that the generational differences about benefit needs and preferences are not just reflections of age. Younger workers, particularly those in many smaller organizations that were hit very hard by the recession, and who are unsure about the future of Social Security, have a different benefits perspective than older generations.”

The survey was reported by World at Work, a national employer-resources firm, which also noted that Gen X and Gen Y members, who collectively comprise 56% of the workforce, recognize that a broad range of benefits carries a cost, and they are more willing than their predecessors to bear some of those costs, despite the financial stresses many of them are feeling in the current economy.

“Two-thirds of Gen X and Gen Y would rather pay more than lose those benefits,” D’Amaddio said, again citing the MetLife survey. In fact, 54% of younger workers would be interested in having a wider array of benefits options even if means paying the full cost of certain voluntary benefits, such as life, dental, vision, disability, critical illness, or homeowner/auto insurance.

Such workers are essentially making a cost-benefit calculation between the cost of premiums for some coverages — which can be as little as $3 or $4 per week — and the the benefit, which is often a predetermined lump sum, with few strings attached, paid when a covered event occurs, such as an accident or a debilitating illness such as cancer, stroke, or heart attack, Mooradian and Lambert note.

Voluntary benefits, they write, “offer simple, affordable solutions to very real problems. An average accident policy, for example, costs an employee about $3.75 a week — about the same as a cup of coffee and a doughnut.”

And the terms, they note, are straightforward. “If an employee’s child falls off the swingset and breaks her wrist, the policy could pay $400 to be used for any purpose. If an employee slips and dislocates a shoulder, the policy could pay $500. Unlike core health and disability benefits, the money from this accident policy can be used to pay anything from uncovered medical costs to household expenses such as a utility bill. For rank-and-file employees, getting cash in hand during a difficult time is crucial to their financial well-being.”

Voluntary benefits can bring peace of mind during more serious medical situations as well, said Timm Marini, president of FieldEddy Insurance.

“We do a lot of voluntary benefits,” he said. “Historically, it’s been dental and disability, but all of a sudden, more and more, it’s critical illness and cancer coverage, things of that nature. That’s the hottest trend right now.”

That development may be in response to a couple of colliding trends — the fact that Americans are living longer than ever, often with chronic conditions, and the ever-soaring costs of health care, particularly for older and sicker patients.

“I think a lot of this is congruent with the life tables going up — more and more people are living longer, the medicines are better, and they’re living longer even with cancer and things of that nature,” Marini said. “Diseases are certainly as preventable as they’ve ever been, and the success rate is higher in treating cancer and putting it into remission.”

When Trouble Strikes

Studies increasingly show that families appreciate the way VBs allow them some spending flexibility during a rough patch. According to MetLife’s annual survey, having enough money to cover bills during sudden illness is the number-one concern of 63% of full-time employees and 75% of young families with children.

“One of the biggest issues facing America’s working families during a health crisis isn’t the cost of care itself,” Mooradian and Lambert point out. “It’s the loss of cash flow that results from being out of work, coupled with uncovered expenses associated with aftercare and treatment. If a family is living paycheck to paycheck, having the primary breadwinner miss a week of work has a significant impact on their financial stability.”

D’Amaddio also noted that voluntary benefits are convenient, in that they’re paid with a payroll deduction, and they are typically transferrable, so workers can take these benefits with them when they change jobs. “They’re not tied directly to the employer — and with the transient nature of employment right now, people aren’t staying 40 years with the same company, and they can take these benefits with them wherever they go.”

In addition, according to MetLife’s annual survey, 55% of employees feel that payroll deductions for voluntary benefits help them to be more disciplined about saving. This discipline — coupled with the financial safety net the benefits provide — can also translate into increased enrollment in company-sponsored 401(k) plans. At the very least, the report suggests, accident and critical-illness insurance might help curb a trend toward increasing credit-card debt incurred by participants in high-deductible health plans.

And companies are beginning to see quality VBs as retention tools. The MetLife survey suggests that employees who feel good about their company’s benefit package are much more likely to enjoy their jobs and to feel loyal to their employers.

“In small to mid-sized companies, when Joe or Jill has a heart attack, everyone knows about it,” Mooradian and Lambert write. “A $10,000 critical-illness payout within weeks of a diagnosis becomes good news that travels fast. Maybe that’s why critical-illness coverage is experiencing double-digit growth.”

But D’Amaddio cautioned employers about who they partner with to administer such benefits.

“We’ve heard some horror stories,” she told BusinessWest. “You want to make sure your partner is all about service for your employees, because an employee might say, ‘this is a great benefit, even if I have to pay for it’ — until they can’t get a claim processed, or they can’t get hold of a representative, or the service is inadequate. Then it becomes a detriment.”

In most cases, however, voluntary benefits are proving to be a key safety net for employees, one they’re more than happy to pay for.

Joseph Bednar can be reached at [email protected]

Safety Net

By BusinessWest Staff August 28, 2012

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Family Matters

By BusinessWest Staff June 5, 2012

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Third Generation of Ross Insurance Agency Looks to the Future

Kevin Ross says he and Maureen Ross O’Connell work well together because they understand where each excels.

While Maureen Ross O’Connell said that her father didn’t want her to work at the family’s insurance company during her college years, her brother, Kevin Ross, laughed and said he knew since he was 5 years old that the company would one day be in their hands.
“I can remember my father bringing me into his office, and as a kid I would point to a desk and say, ‘that’s mine, dad!’” he remembered with a laugh.
Today, the siblings comprise the third generation of their family to run Ross Insurance Agency Inc. Their brother, Ernie, was also part of the team until he passed away last year. Sitting down with BusinessWest recently, the partners offered a look into an agency that, in many intriguing ways, is looking squarely to the future.
Like many family-business owners, both Ross and O’Connell said that their best education came from the daily interaction and on-the-job words of wisdom from the generation before them. And having grown up in the agency together, Ross added, the siblings have honed their collaborative technique.
“Family businesses have their struggles,” he acknowledged. “Every one of them does, and I won’t say that we don’t sometimes. But we know where we excel. Maureen runs the inside of the house, administration, the staffing, company communications, and I’m in sales. We play off each other, and that’s why it’s been so successful.”
And it isn’t just the walk-in, brick-and-mortar business where Ross Insurance excels. The partners long ago recognized the changing marketplace for their service-based industry, and have been steadily trending in the direction dictated by technology.
Like a seasoned IT whiz, O’Connell explained both how the firm has maintained a regularly updated insurance blog, and the efficacy of spiking its professional online presence with current information, all for the purposes of search-engine optimization (SEO). “When people Google, we want to be right up there,” she continued. “We’ve been working very hard on organic SEO for almost a year and a half. It’s been very beneficial.”
But as the third generation talked about the shifting sands of technology and how it impacts their industry, they stopped before a wall of photos in their office. In front of this large grid of Little League team pictures, all sponsored by Ross Insurance, O’Connell said, “as much as this digital age allows us to grow, it’s not to say that this community and this local piece isn’t important.”

Shop Talk
O’Connell and Ross are just the latest generation to put their stamp on the company — and they are well aware of all the contributions needed to take the venture to this point in its long history.
“In 1925 our grandfather, George Ross, had a grocery store in Holyoke,” Ross said. “But he decided that he wanted to get into the insurance business instead. Holyoke was growing and booming, and he saw it as a real opportunity. So he started the business from scratch.”
In the years after World War II, his sons, George Jr. and Ernie, and son-in-law Jim Gorman took over the firm. Returning to the story of her first days in the company, O’Connell said that she had always been a diligent worker — “I didn’t play any sports in high school; I worked.
“When I entered college, my father insisted that I quit work and devote my time to my studies,” she continued, adding with a laugh, “I was furious!”
The time soon came for Ernie to revisit his moratorium on her collegiate employment. “He called me one day in November,” she remembered. “The business had recently moved from Suffolk Street to High Street. And basically, he said, ‘the bills aren’t getting out — can you come and send out statements?’ It didn’t take me long to say, ‘sure!’ I was going to get paid, it was work, I was thrilled.
“I finished that job before the day ended,” she continued, “so my uncle had me start another project. That wasn’t finished by day’s end, so I had to come back, and then that went on for several days. Finally my uncle said to my father, ‘either give her a job or let her go.’ And so my Uncle Jim hired me as a file clerk. That was my first official job here.”
Meanwhile, her sibling contrasted this story with his own tale, as an early adopter of the family business. “I went into the office with dad on nights and weekends,” Ross said. “I just knew from day one that this is what I wanted to do. I went to business school at Bryant, and there was no question about it; I was coming into the family business.”
While their stories might have diverged up to that point, once they were part of the staff, the two spoke similarly of the benefits of working in a generational family business.
“From my perspective as an in-house employee with my beginnings here,” O’Connell said, “dad was harder on me than any of the other staff — from day one.
“But we had the greatest working relationship,” she went on. “I learned everything from that second generation. I would come in the morning, grab a coffee, and sit at the spare chair at my dad’s desk and just hash things out — talk about the business, where we were going, what we were doing. I loved working with them.”
With Ross nodding in agreement, she added, “it was sad, very sad, when they all retired.” Their father eventually bought out his partners in the firm, and when the time came for his legacy to be built upon by the next generation, both O’Connell and Ross said the transition was as smooth as could be expected.
“In the last few years of his owning the business,” Ross explained, “he went into semi-retirement and passed the reins of operation over to us, which gave us valuable education, but also gave him a comfort level, knowing that, when he was ready to sell out, we could take it on successfully.”

Linked In
Pausing to reflect back on her earliest days in the firm, O’Connell recalled her first official job at Ross, in claims. “In those days we paid our own claims. So that means a customer would call in with a claim, I go into Jim’s office, ask him if it was a payable claim, he’d have me pull the form, and from that moment on, every claim that came in, I’d pull the form. He made me research every single claim. It was the best education I could ever have gotten in the industry.”
The pair’s professional development in many ways mirrors their industry. O’Connell said that, while the office isn’t paperless — yet — much of its registration and filing is streamlining in that direction. Their marketing budget has seen a similar shift.
“Years ago, quite a bit of our business was walk-in,” Ross added. “We were on High Street, and that’s the way things were done. Now, we have an employee who handles all of our social media. We post four blogs a week on our on-site blog, and we post to our off-site blog. And the bottom line is that this works for our SEO.
“The first thing the modern consumer does before he makes a purchase, he gets on the computer,” he continued. “We want to be the first agency that pops up, so we get the opportunity to deal with that person. Maureen really has been spearheading this process.”
The new walk-in customer, she said, is anywhere with an Internet connection. “We’re writing policies across the state,” she said. “We wrote a workmen’s comp policy for a business in Hawaii. They had a salesman in Massachusetts, and they had to have a workmen’s comp policy. Their agent couldn’t provide it, so they got in touch with us.”

Neighborhood Watch
O’Connell said that the firm is in the formative stages of digital growth.
“But while the digital age is very young, we think it’s the future of our business,” she continued. “So we’re embracing that and working as hard as we can to make that a very important part of our future. We’re growing without bricks and mortar.”
However, in talking about the future of their industry, both O’Connell and Ross gestured to that wall of Little League pictures. “We’re a committed, third-generation business in our community,” Ross said. “Maureen and I spend a lot of time trying to grow our business and be the best answer for all of their questions and needs. But it’s also important to give back to the fabric of our community. Immediately since we took over in 1990, we paid close attention to two areas — youth and education; they’re important to us.”
O’Connell said that is the difference — a locally based family business maintaining its community roots. “When auto insurance in Massachusetts went competitive in 2008,” she added, “we first had the Geicos, Progressive, all of them. To compete with that, we have to be an important part of our community, giving back to it. The direct writers don’t do that. They don’t care.”
As part of the ongoing renovations at the Holyoke Public Library, O’Connell and Ross have created the Team Ernie Charitable Golf Tournament; the goal is to raise $60,000 for the construction project, and in turn the newspaper and periodicals room at the new facility will be named for their late brother.
Speaking to the technology that has secured their generation’s ascent into the digital age, O’Connell said that, while it is necessary to have a strong online presence, some things will never change.
“Yes, we want to be straightaway on Google searches,” she said. “Otherwise, you’re not getting that primary opportunity. And then you get the chance to show them the personalized customer service.
“Face to face is not obsolete,” she added. “But it is important to get them here first.”

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