Tag: Georgia

Are You Ready for the 2013 Hurricane Season?

For those living or working in areas at risk of experiencing a tropical storm or hurricane, June 1st rarely passes unnoticed. At Setnor Byer Insurance & Risk, we understand that preparing for Hurricane Season is rarely easy and often stressful. We also understand that a lack of awareness and preparation can make a bad situation worse, and that the best way to limit the risk is to take preventative steps now.

The National Oceanic and Atmospheric Administration (NOAA) estimates a 70 percent probability that the 2013 Hurricane Season will bring:

  • 12 – 18 Named Storms (winds of 39 mph or higher)
  • 6 – 10 Hurricanes (winds of 74 mph or higher)
  • 3 – 6 Major Hurricanes (winds of 111 mph or higher)

These estimates indicate that activity will exceed the seasonal average of 11 named storms, six hurricanes and two major hurricanes.

According to NOAA administrator Jane Lubchenco, Ph.D., “the United States was fortunate last year. Winds steered most of the season’s tropical storms and all hurricanes away from our coastlines…However we can’t count on luck to get us through this season. We need to be prepared, especially with this above-normal outlook.”

Though different situations call for different measures, the following tips can assist you in developing your own plan for dealing with the 2013 Hurricane Season.

Before the Storm

  • Monitor the news to allow time to prepare.
  • Identify all tools and equipment that will be needed to secure property before a storm and limit the damage after the storm (flashlights, batteries, caulking, tarpaulins, sandbags, cutting and fastening equipment, etc.).
  • Clear drains and downspouts to minimize the risk of flooding.
  • Move items inside.
  • Unplug electrical equipment and move property away from windows.
  • Check and secure all documents and records.
  • Take or update photographs of real and personal property.
  • Gather insurance policies and agent/insurer contact information.

After the Storm

  • Only after it has been declared safe to do so, look for any property damage and take reasonably necessary steps to protect against any further damage.
  • Report fallen power lines to power company immediately–stay away from them!
  • Check exterior walls and roof for damage from wind, rain, flying objects and rising waters (flood insurance).
  • Check all interior perimeter walls, floors, and roof for leaks and water damage.
  • Document all damage with photographs and video.
  • Prepare detailed damage reports.
  • Call your insurer or agent as soon as possible to report damage.

While preparing for Hurricane Season is never easy, our team of experienced and responsive professionals can work with you to make sure that your home, cars and property are protected.

For over 30 years, Setnor Byer Insurance & Risk has been helping our clients prepare before the storm and rebuild after. Our clients benefit from a Hurricane Insurance Program that includes an emergency and after hours claims service hotline in addition to guidance for disaster planning.

If you would like more information about how Setnor Byer Insurance & Risk can help you prepare for the 2013 Hurricane Season, contact us.

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Clearing a High Health Insurance Hurdle: the Pre-Existing Condition Insurance Plan (PCIP) Program

There is a new option for those who are uninsured because of a pre-existing condition—the Pre-Existing Condition Insurance Plan (PCIP) program. Created by the Patient Protection and Affordable Care Act (the health reform law), the PCIP is designed to make health coverage available to those with pre-existing conditions. Importantly, the PCIP does not cost enrollees more just because of their medical condition.

The U.S. Department of Health and Human Services runs the PCIP program in twenty-three states and is contracting with a national insurance plan to administer the program. These states are: Arizona, Alabama, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Nevada, Nebraska, North Dakota, South Carolina, Tennessee, Texas, Vermont, Virginia, West Virginia, Wyoming, as well as the District of Columbia.

The remaining states are running their own pre-existing condition insurance plan programs. As a result, application procedures, costs and benefits for these state-run programs may differ not only from the federally-run PCIP, but also from other states.

Under the federally-run PCIP program, a broad range of health benefits are covered, including primary and specialty care, hospital care and prescription drugs. Benefits provided by these PCIPs are available even if they are used to treat a pre-existing condition.

To qualify for coverage under the PCIP program, a person:

  • Must be a United States citizen or legal resident;
  • Must have been without health coverage for at least the previous six months; and
  • Must have a pre-existing condition or have been denied coverage because of health a condition.

The PCIP program offers three plan options:

  • The Standard Plan;
  • The Extended Plan; and
  • The HSA Plan.

Each plan has its own premiums, calendar year deductibles, prescription deductibles, and co-payment requirements. However, all three plans pay for preventive care at 100%, with no deductible when a preventive diagnosis is indicated by an in-network doctor. Preventive care includes annual physicals, flu shots, routine mammograms, and cancer screenings. For non-preventive care, insureds staying in-network will pay 20% of their medical costs after satisfying the deductible.

Despite being a federally-run program, PCIP premiums may vary by state. For example, premiums are higher in Texas than they are in Florida.

In Florida, the monthly premiums for people 18 years old or younger are $118 for the Standard Option, $158 for the Extended Option, and $122 for the HSA Option. In Texas, the premiums are $133 for the Standard Option, $179 for the Extended Option, and $138 for the HSA Option. Similarly, those living in Florida ages 35 to 44 years old will pay $211 for the Standard Option, $284 for the Extended Option, and $220 for the HSA Option. In Texas, the monthly premiums are $239 for the Standard Option, $323 for the Extended Option, and $248 for the HSA Option.

Under this program, the first premium payment is due within 30 calendar days from the date an approval letter is received; otherwise the application will be cancelled. The effective date of coverage depends on the date the application and all supporting documents are received by the PCIP. If the documentation is received on or before the 15th of the month, coverage will be effective on the first day of the next month. If documentation is received after the 15th of the month, coverage will be effective on the first day of the second month.

If an application for coverage under the PCIP is denied, the applicant will receive a letter explaining the reasons for such denial. These applicants have 45 days to file an appeal of their denial, if they so desire. Otherwise, they are free to re-apply for PCIP coverage upon meeting the eligibility requirements.

The PCIP program is only available until 2014. This is because in 2014, insurance companies will be prohibited from refusing to sell coverage or renew policies because of a person’s pre-existing condition. Additionally, in 2014, individuals whose employers don’t offer them insurance will be able to buy insurance directly in a health insurance exchange.

For those who have been unable to get health insurance due to a pre-existing condition, the PCIP program may be the solution they have been looking for. However, given the disagreement and uncertainty surrounding health care reform, even after the Supreme Court upheld nearly every provision of the law, only time and experience will tell if the PCIP program is in fact what it was designed to be.

At Setnor Byer Insurance & Risk, we are committed to guiding you through the rapidly changing health care landscape. Be sure to check back with us periodically for future informational updates. In the meantime, if you have specific questions about health care reform or if you are ready to take action and would like to see how Setnor Byer Insurance & Risk can help, contact us.

Is Fear of Liability Why Your Condominium Community Does Not Have an Automated External Defibrillator (AED)?

According to the Centers for Disease Control and Prevention, approximately 785,000 Americans suffer their first heart attack every year, while another 470,000 experience their second. Unfortunately, the number of those who die from sudden cardiac arrest is equally disturbing.

Medical experts generally agree that the key to surviving a heart attack is timely implementation of the Chain of Survival, which is a metaphor often used to describe the elements of appropriate treatment in the case of a heart attack. An important link in this chain is defibrillation, which involves providing an electric shock to the victim’s heart.

Thousands of deaths could be prevented each year if heart attack victims receive prompt defibrillation. Automated external defibrillators, or AEDs, are designed to provide instant defibrillation to those in need. AEDs are portable devices that guide users through the process by audible or visual prompts without requiring any discretion or judgment.

Technological advances have increased access to AEDs, which are now found anywhere from the local gym to the neighborhood supermarket. Despite their benefit and increasing affordability, many condominiums do not purchase AEDs for fear of exposing their association to liability if something goes wrong. Though potential liability is always a legitimate concern, in the context of providing AEDs to condominium residents, various laws are in place to protect the condominium association.

In the Cardiac Arrest Survival Act of 2000, Congress found that limiting the liability of Good Samaritans and acquirers of AEDs in emergency situations may encourage their use and save lives. Since then, many states have enacted their own laws to protect those who use AEDs or otherwise make them available.

In Florida, civil immunity is available to those who cause harm when using or attempting to use an AED in a perceived medical emergency. Under certain circumstances, any person who acquired the device and makes it available for use, including condominium associations, may also be entitled to immunity. Additionally, Florida law provides that an association’s general liability insurance policy may not exclude damages resulting from the use of an AED.

Like Florida, Georgia provides civil immunity to those making AEDs available, and to those who provide emergency care or treatment with an AED. In North Carolina, a person providing care with an AED and the person responsible for the site where the AED is located are similarly immune from civil liability arising from the use of the AED.

Relying on these laws, condominium associations can provide the life-saving benefits afforded by AEDs without necessarily creating additional liability. However, the immunity afforded by these laws is not automatic or absolute. Rather, each state’s laws generally contain various, often unique requirements which must be met to enjoy the immunity.

For example, in Florida, immunity is only available if a qualifying AED is involved. To qualify for immunity in Florida, the AED must be a lifesaving defibrillator device that:

  • Is commercially distributed in accordance with the Federal Food, Drug, and Cosmetic Act;
  • Is capable of recognizing the presence or absence of ventricular fibrillation, and is capable of determining without intervention by the user of the device whether defibrillation should be performed; and
  • Upon determining that defibrillation should be performed, is able to deliver an electrical shock to an individual.

In North Carolina, immunity is lost if the injury or death resulting from the use of an AED was caused by gross negligence, wanton conduct or intentional wrongdoing on the part of the person rendering the treatment. In Georgia, the emergency care must be rendered gratuitously, in good faith, and without objection of the person to whom care or treatment is rendered.

Despite similarities among many states’ statutes, there may be some very significant differences. Consequently, before electing to purchase an AED for their community, condominium associations must understand and ensure compliance with each and every applicable statutory requirement. Given the consequences of failure, condominium associations should consider seeking legal advice during the decision-making and implementation process.

Access to an AED may save a life. If a condominium association does not have an AED for fear of increased liability exposure, then a closer look at any applicable immunity laws should be considered. Despite these laws, however, condominium associations must maintain a healthy fear of liability to ensure compliance with any statutory requirements. Otherwise, the very immunity that initially compelled the purchase of an AED will be replaced with the liability exposure the condominium association always sought to avoid.

Clients of Setnor Byer’s Condominium Program enjoy access to various risk management services, such as Setnor Byer’s Risk Management Group and Unit Owners’ Report Line, as well as our affiliate’s Board Member Education Certification, which has been approved by the Division of Florida Condominiums, Timeshares, and Mobile Homes.

If you would like to learn more about controlling condominium association risks, or if you would like to discuss how we can serve you and your association, please contact us.

“Young People Need Not Apply”: The Legality of Adult-Only Condominium Communities

As a country of laws, the United States has gone to great lengths to ferret out and eliminate discrimination, having deemed it antithetical to a free and fair society. Federal and state statutes are replete with anti-discrimination laws that affect virtually every facet of modern life. Interestingly, and perhaps ironically, one such law that was enacted primarily to eliminate discrimination expressly legalizes it against a particular group – the “young.”

Title VIII of the Civil Rights Act of 1968, known as the Federal Fair Housing Act (FHA), protects all citizens from discrimination in housing and real estate-related transactions on the basis of race, color, national origin, religion, sex, handicap, or familial status. The prohibition against discrimination on the basis of familial status, including an exemption for “older” persons, was added to the FHA in 1989. However, unclear drafting of the exemption led to significant confusion regarding its interpretation. In 1995, the confusion surrounding the exemption was addressed by the Housing for Older Persons Act (HOPA). Under the HOPA, the FHA’s prohibition against discrimination on the basis of familial status does not apply with respect to “housing for older persons,” a designation that includes condominiums. As a result, this exemption essentially gives a condominium association the authority to exclude “young people” from living in a community.

The HOPA designates three types of housing communities as eligible for consideration as “housing for older persons,” thereby qualifying them for the exemption from the FHA’s anti-discrimination provisions. The first type includes housing provided under any state or federal program that is specifically designated and operated to assist elderly persons. The second type includes housing that is intended for and solely occupied by, persons 62 years of age or older. The third type is housing for persons 55 years of age or older, the category into which some condominiums fall.

To qualify for the HOPA’s third type of exempt housing, the community must be intended and operated for occupancy by persons 55 years of age or older. The following factors may be considered relevant when determining whether or not a community has exhibited the necessary intent to operate as housing for persons at least 55 years of age:

  • The manner in which the community is described to prospective residents;
  • Any advertising designed to attract prospective residents to the community (although phrases such as “adult living” or “adult community” are insufficient to meet this requirement);
  • Lease provisions;
  • Written rules, regulations, or covenants adopted by the community;
  • The maintaining and applying of relevant procedures to community governance;
  • The community’s actual practices; and
  • Public postings in the community’s common areas.

This intent must also be evidenced by published policies and procedures to which the community adheres.

In addition to displaying the requisite intent, at least 80% of the occupied units must be occupied by at least one person who is 55 years of age or older. To calculate this figure, the total number of units in the community must be counted. From that number, the following units should be excluded from the calculation of the 80% requirement:

  • Units that have been continuously occupied by the same residents since September 13, 1998, none of whom are or were 55 years of age or older;
  • Unoccupied units;
  • Units occupied by employees of the community who are under the age of 55 and who provide substantial management and maintenance services to the community; and
  • Units occupied solely by persons who are necessary or essential to provide medical or health and nursing care services as a reasonable accommodation to residents.

From the remaining units, the percentage of units that are occupied by at least one person age 55 or older should be calculated.

The community must also comply with any applicable rules governing the verification of these occupancy requirements. Generally, verification of compliance with the 80% requirement must be done using reliable surveys and affidavits. Additionally, the validity of such information, whether obtained through surveys or other means, must be verified at least once every two years. The HOPA also contains several safe-harbor provisions that protect the designation as “housing for older persons.”

In addition to the HOPA, states have similarly exempted “housing for older persons” from their own anti-retaliation laws. For example, Florida’s Fair Housing Act and Georgia’s Fair Housing laws use language that is virtually identical to the HOPA with regard to exempting housing for older persons. Additionally, those communities that wish to be recognized as exempt “housing for older persons” may need to register with the appropriate state administrative office, such as the state of Florida’s Commission of Human Relations.

Despite its discriminatory effect, the HOPA has survived constitutional challenges because courts have held that Congress acted reasonably in enacting the HOPA to protect the interests “of senior citizens who live in retirement communities,” many of whom may have a particular need for an affordable, safe, and supportive environment. The exemption provided by the HOPA allows these communities to devote more resources to facilities and services for older persons, and fewer if any resources for schools, daycare facilities, and child safety programs. These are but some of the social benefits provided by this unique type of discrimination in the housing context.

Condominiums seeking to implement or maintain a community that provides “housing for older persons” have to jump through many procedural, and, depending on applicable state law, administrative hoops. However, since the HOPA runs contrary to the nation’s deep-rooted egalitarian ideals, such policing measures are certainly appropriate when permitting forms of discrimination not usually tolerated in other contexts.