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Buying Sight Unseen

Purchasing a car and life insurance online have many similarities.  People buy cars regularly sight unseen. You can go to Ebay or a national dealer like CarMax and find a car and have it shipped to you from anywhere in the United States. One of the most attractive aspects of buying a car online is you do not have to see a salesperson.  Like a purchase of a car online, buying life insurance online does not require you to see a salesperson either.   There are some lessons to be learned from car buying online that can help you when shopping for life insurance online.

If you purchase a car online, you want to see a picture.  How do you see a picture of a life insurance policy?  What you are insuring is your family’s financial well-being, that is the picture of a life insurance policy.

family-car

Let us put it into numbers.  With cars and life insurance, size of your family matters.  If you have a family of four, you probably will look for a four-door family vehicle.  If you have a family of four, your life insurance will need to settle your debts and replace your income if you are not in the picture any longer. Let’s add up a few numbers as an example for a young couple, both earning $50,000 a year.

$30,000 car note. The average new light vehicle priced by Kelly Blue Book is $34,372 [i].

$14,000 household debt. The Federal Reserve[ii]  says the average household debt is $14,452

$157,000 average mortgage. Business Insider reported this information from Experian [iii]

$28,950 average student debt. Reported by the Institute for College Access & Success [iv]

$490,680 cost of raising two children. Reported by The Department of Agriculture [v]

$10,864 Final expense cost as reported by CSG Actuarial & LIMRA [vi]

$ 253,622 Cost of educating two children at an in state four-year college [vii]

Using the life insurance calculator from the non-profit organization Life Happens and this average debt information you can estimate that one parent’s life insurance needs at $356,278[viii].   If you fill the calculator in with your personal information, you will probably come out with a different number.  The $356,278 gives us a point to use as an example.  Here is a screenshot of the calculations page so you can see how I arrive at the recommended life insurance amount.  This calculator is available for free at www.Advice4LifeInsurance.com

life-happens-calculator

To make our conversation easier, let us round the number up to $360,000.  In comparison, if you know you need a four-door car, you now want to look at the reliability of the manufacturer.  In selecting life insurance, if you know you need a $360,000 policy, this would be the point where you want to look at the suitability of the policy and the financial strength of the life insurance company.

There are dozens of websites on the internet to select life insurance companies.  Most of them require that you provide your personal information before you decide what life insurance company you want.  That is why I designed the life insurance calculator on Advice4LifeInsurance.com to offer life insurance company options before you enter your personal information.  If you enter in some basic information, you can see which life insurance companies offer the policy for which you are shopping.

life-insurance-quotes

If you are shopping for a car, you do not stop at the price.  You look at manufacturer reports and surveys.  Most life insurance sales sites on the internet stop at this point and ask you to sign up.  Not so fast.  There are more questions to answer.  In buying a car, you look at the dependability of the manufacturer.  In life insurance, you look at the financial strength of the life insurance companies you are considering.  In some instances, there may be several life insurance companies that are only a few dollars apart.  If you see a life insurance company that you have questions about, the next step is to visit our ratings page at Advice4LifeInsurance.com [ix]

On that page, I list three of the most prominent financial rating services and the Comdex rating along with their rating of dozens of insurance companies.  The Comdex rating takes all four of the most prominent financial rating services and cumulates them into a scale that goes from 0 to 100. The theory behind the Comdex rating is the higher the financial rating, the better the financial strength of the company.  Rating services charge a substantial fee for their rating, so not all insurance companies choose to be rated by all four rating services.

You can buy a car and life insurance online, however, that does not mean that you should not speak with the person from whom you are buying. If you found the right car at the right price, the next step that most people take is to call and inquire about the car.  That is the same thing that you should do when buying life insurance online.  After you have determined the amount of life insurance that you want, found the price that is within your budget, and narrowed the selection of the company down, it is time to complete the application and talk to the person from whom you are buying.  You do not have to submit payment to begin the application and you can back out of the application at any time.  Even after you buy the policy you have 30 days to change your mind and get a refund.  The attractiveness of buying online is that you do not have to meet with a salesperson.  It is much easier to say no thank you on the phone.  However, remember not to rush through the process. Verification and communication are vital. If you do both, you are well on your way to a smooth transaction and purchase that will protect your loved ones for many years.

References

[i] Kelly Blue Book. “New-Car Transaction Prices Increase Nearly 3 Percent Year-Over-Year In September 2016, According To Kelley Blue Book – Oct 3, 2016.” MediaRoom. Last modified September 2016. http://mediaroom.kbb.com/2016-10-03-New-Car-Transaction-Prices-Increase-Nearly-3-Percent-Year-Over-Year-In-September-2016-According-To-Kelley-Blue-Book

[ii] Federal Reserve Bank of St. Louis. Households and Nonprofit Organizations; Credit Market Instruments; Liability, Level – FRED – St. Louis Fed. Board of Governors of the Federal Reserve System, 2016. Accessed October 17, 2016. https://fred.stlouisfed.org/graph/?id=CMDEBT

[iii] Kiersz, Andy, and Libby Kane. “Mortgage Balance State Map.” Business Insider. Last modified October 14, 2014. http://www.businessinsider.com/mortgage-balance-state-map-2014-10

[iv] Institute for College Access & Success. “State by State Data 2015.” Project on Student Debt. Last modified 2015. http://ticas.org/posd/state-state-data-2015.

[v] U.S. Department of Agriculture. “Parents Projected to Spend $245,340 to Raise a Child Born in 2013, According to USDA Report | USDA Newsroom.” Newsroom. Accessed October 18, 2016. http://www.usda.gov/wps/portal/usda/usdahome?contentid=2014/08/0179.xml.

[vi] CSG Actuarial. “Final Expense Insurance Sales Nearly $400 Million in 2013, Life Insurers Council and CSG Actuarial Report.” CSG Actuarial. Last modified September 8, 2014. https://www.csgactuarial.com/2014/09/final-expense-insurance-sales-nearly-400-million-in-2013-life-insurers-council-and-csg-actuarial-report/.

[vii] College Board. “Average Published Undergraduate Charges by Sector, 2015-16.” Trends in Higher Education. Last modified 2015. https://trends.collegeboard.org/college-pricing/figures-tables/average-published-undergraduate-charges-sector-2015-16.

[viii] Richards, Van. “Life Happens Life Insurance Calculator.” Advice 4 Life Insurance. Last modified October 18, 2016. https://www.advice4lifeinsurance.com/

[ix] Richards, Van. “Ratings.” Advice 4 Life Insurance. Last modified October 14, 2016. https://www.advice4lifeinsurance.com/ratings.html

 

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Good Financial Advice

When was the last time that you asked for a second opinion on your finances?  Money is one of those subjects that is hard to bring up in conversations.  If you talk about money with friends it may open your life more than you want or more than your friends, want to know.  The hesitation to discuss money also brings up the problem of trust. Just where does a non-financial person go for financial advice that can be trusted?  Here is the short answer:

Employee benefits education at work

CPA’s and attorneys

Fee-based financial planners

Stockbrokers

Investment product providers

Life insurance companies

Life insurance agents

Credit union

Banks

Robo-advisers

The internet

What are the pros and cons of the various sources of information? Here is some brief insight into the different sources of financial advice.  This is not meant to be the end-all of financial information sources, but rather enough information to point you in the right direction.

Employee benefit education is a major source for many people, and its reliability is getting a big boost.  In April of 2017, new laws go into effect mandating that all employer retirement plan information be in the best interest of the employee (Department of Labor, 2016).  That does not mean that all employee benefit information will be equally informative.  It also does not mean that employers are entirely responsible for employees’ financial lives.  It does mean that the financial advice concerning the retirement plan should be dependable.  How you relate that information to other aspects of your finances is up to you.

Stockbrokers have changed over the past fifty years.  Stockbrokers used to be just what their name implied, someone that bought and sold stock.  They did not offer much unbiased advice because they usually worked for an investment banker that was organizing the sale of a company’s stock.  As time has progressed, stockbrokers have become less sales-oriented and more concerned about if they are offering financial products that are in the best interest of their clients.

Investment product providers are mutual funds purchase directly from the provider or a unit investment trust sometimes shortened to UIT’s.  There are some providers that offer good advice, but remember that they still do not have a high responsibility to sell the products that are best for you.  They have certain regulations that they have to follow. For example, they are not supposed to say things that are blatant lies.  Moreover, they are not supposed to sell their products to people that they find are financially unqualified.  However, your overall best interest is not their legal duty.  To some degree, it is still buyer beware.

Life insurance companies have some similarities.  Like the investment product providers, they are not supposed to stretch the truth.  However, the average person is far from qualified to understand some of their products, making the need for an experienced agent more important.

Life insurance agents are separate from the life insurance companies in this information because there are many life insurance agents that are independent.  The autonomy of an independent agent does give their financial advice less likelihood of being biased. However most financial advice from life insurance agents will be compartmentalized to deal only with the financial aspects related to their products.

Credit unions remain a good source for financial products and information.  They sell credit union and life insurance products.   Nevertheless, just like any product provider, it is up to the customer to be sure that they are buying a product that they understand and can afford.

For a long time, banks were perceived as the gold standard of safety.  Recently that image has fallen because one big bank let its branches get out of control and cost its customers millions of dollars.  It gives the impression to the average person that they cannot trust banks any longer. Time will tell how that circumstance gets resolved and if their image will improve.

Fee-based financial planners are perceived as one of the most unbiased parties when dealing with money.  They do not sell products so their primary incentive is client fees.

CPA’s and attorneys are listed together.  However, it has been my experience that many more CPA’s deals with financial issues than attorney’s.  If you are looking for financial advice, a CPA or attorney will be very straight forward in telling you if they will or will not be able to help you. Some of these professionals have expanded their practice to include fee-based financial advice.  Because of their level of fiduciary duty, I would not have any reservations in stating that if a CPA or attorney provides financial advice as part of their service, it is dependable.

Robo-advisors have become a new option available for financial advice, and some are trustworthy sources of financial information.  The creators of robo-advisor services have taken the modern theories that are used to manage investments and put them into a computer program.  Plug in the parameters of your financial situation and the program will produce what is considered to be an appropriate investment allocation.  As the economy changes or personal financial circumstances change the program can alert customers of changes automatically or prompt customers to manually make changes.  Do robo-advisors work?  The reliability of robo-advisors is as good as the creator, person, or team that is managing the program.  Just as in the quality of investment advice that you obtain from real people depends upon the individual you are entrusting.  According to a study done by pollster Gallup, only 5% of U.S. investors use robo-advisors and an astounding 80% state that “they are not likely at all to use a robo-advisor” (Gallup, Inc.,2016).

flashing-red-lightIf I could post a big flashing red warning light on the page, this would be the place to put it.  The internet is an option that most people will turn to for financial advice however we should all be wary of internet financial advice because of the prevalence of scams.  It takes no financial experience, education or certification to start a website.  That is reason enough to be cautious. You may have found this article by surfing the internet for financial advice.  How do you know you can trust it or me?  The fact is you do not.  Ask yourself, does the source sound rational and can you research the advice?

When judging the quality or usefulness of any financial advice there is a reliable standard.  If a circumstance sounds too good to be true, it probably is.  People get caught up in scams because they find an answer to a problem or concern that they have and the solution they find seems to fit just right.  We all have some degrees of trust in us.  We could not live daily without some trust.  We believe a total stranger when we ask them the time of day.  Trust gets a little more away from personal control when we ask for information that will impact part of our life.  The education system teaches students to trust one another in projects.  Everyone’s grade in a group project depends on each other.  We trust colleagues at work when we share responsibilities.  However, even in these examples, you can see there is room for lapses in confidence.  As we broaden the circle of trust to encompass other aspects of our lives such as finance, reasons to mistrust widens.  There are people in our world that are putting their personal interest ahead of your best interest.  The cold hard fact is that there are people in our world that set out to deceive others.  How can you be sure that you are not getting advice for your money from a con-artist?

In her book, The Confidence Game, Maria Konnikova tells the fascinating story of Dr. Joseph Cyr, a surgeon in the Royal Canadian Navy (Konnikova, 2016).  Dr. Cyr was outstanding, he did surgery in the toughest conditions at sea, with little or no help.  The only problem was the Dr. Cyr was not a doctor at all.  He was Ferdinand Waldo Demar, a young man that had not even graduated from high school.  Konnikova’s captivating book looks at the reason why people fall for things that are not real.  She describes the people that commit these charades like this, “Their genius lies in figuring out what, precisely, it is we want, and how they can present themselves as the perfect vehicle for delivering on that desire” (Konnikova, 2016).  The thing we can learn from Konnikova’s insight is that when we are looking to find financial advice, be careful that the solution has not been created to prey on our needs.  If it is too good to be true, it probably is not true at all.

How do you make sure that you are getting sound financial advice?  Over the years I have worked for large firms and even though the firms had billions and billions of dollars under management clients did not rely as much upon the credibility of the institution as much as they did with the person that was in front of them.  Investment firms know this and try desperately to tie their employees to their company.  For the average everyday person or the CEO of the multi-billion-dollar corporation, knowing if you can trust the financial advice of your advisor boils down to work experience, life experiences, references, education, and last but not least common sense.

As people begin their careers, education is paramount.  As the years go by the value of classroom teaching is replaced with the work experiences encountered. Do not take me wrong, education is valuable, especially financial education.  My point is that life experiences have a significant impact on a person’s abilities.  If you are presented with financial recommendations, don’t be shy about asking for references of the advisor’s work.  Don’t be put off if there are not a lot of Yelp, Google or Angie’s List reviews. How some financial advisors interact online is regulated either by the government or their self-regulatory organizations making online research more difficult. If the circumstance warrants, ask for a referral.  Understand this too.  If you are asking for advice on a $35 per month life insurance policy, you probably are not going to get the phone numbers of the advisor’s top ten clients.  Samples of the advisor’s work can also serve as a good standard for trust.  I have mentioned it a several times, and it is worth saying again, the common sense factor is crucial.  If the service or results of services sound too good to be true they probably are not real.  Follow these guidelines, and it will help you in finding good financial advice.

References

Department of Labor. (2016). Conflict of interest rule—retirement investment advice (Volume 81, Number 68). Retrieved from National Archives and Records Administration website: http://webapps.dol.gov/FederalRegister/PdfDisplay.aspx?DocId=28806

Gallup, Inc. (2016). Robo-advice still a novelty for U.S. investors. Retrieved from Gallup Poll website: http://www.gallup.com/poll/193997/robo-advice-novelty-investors.aspx

Konnikova, M. (2016). The confidence game: why we fall for it … every time. New York, NY: Penguin Random House.

 

Van Richards is the owner of Advice4LifeInsurance.com and Advice4Retirement.com he can be contacted at van@advice4lifeinsurance.com or on twitter @VanRichards

Sleep = Life

An alarming number of children and athletes have sleep apnea risk.

          We all sleep. The quality of sleep affects every aspect of our life. What would your day be like if you had an extra hour of sleep? How do you think children would act with an extra hour of sleep? Sleep affects adult work performance and children’s learning ability in school. Lack of sleep accounts for about 83,000 car crashes every year (NHTSA, n.d.) Sleep disorders are linked to a wide variety of health conditions from depression to high blood pressure to increasing the risk of Parkinson’s disease (NIH, 2011). Sleep even affects the cost we pay for life insurance.

          By increasing your quality of sleep, you can give yourself that feeling of extra sleep and improve your future health. Common thought is that we all need about seven hours of sleep per night, some people can get along with less, and children need more. A quick look at some of the reasons people don’t sleep or do not sleep well can help you understand how to get better rest and improve your life. Three areas affect sleep:

  • Physical – what is going on inside the body affects sleep.
  • Mental – how a person thinks does have an impact on sleep.
  • Environmental – sound, temperature, lighting, smell, and touch affect sleep.

            The details of these three areas are the subjects of extensive studies that continue to develop every day. Let’s look a little deeper at the physical aspect of sleep. If you improve what is going on inside your body, your sleep will improve. One of the most prevalent physical conditions that affect men and women is sleep apnea. Suffers from sleep apnea pause or stop breathing while sleeping. The pause in breathing can range from seconds to minutes. The condition is not limited by age; sleep apnea occurs in infants, children, and adults.

            There are several types of sleep apnea however obstructive sleep apnea is the most common.   With this condition, “the airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs” (AASM, n.d.). Obstructive sleep apnea sufferers are often loud snorers and wake up frequently gasping for air. I have obstructive sleep apnea and in the first sleep study I had done, I woke up over 100 times. I never consciously knew this was happening, I only knew that I was always tired.

            The first time I met someone that had sleep apnea, it was a middle-aged friend that was overweight. I thought to myself, thank goodness that is not me. I am not overweight, and I would never use one of those machines with a mask at night. Oh, how cruel time can be. I still don’t consider myself overweight, but according to the Body Mass Index or BMI, I am overweight. However, the validity of the BMI is a topic for another day.

            What led up to my sleep apnea diagnosis seemed to be typical for sleep apnea sufferers: I snored loudly, my wife told me that I would stop snoring then suddenly gasp for air, and I was tired all the time. I could sleep for eight or nine hours and still be tired. By that time, learning to adjust to wearing a sleep mask seemed to be a small price to pay if I could get back that fresh feeling of a good night sleep.

            Most people accept the importance of sleep. The prevalence of sleep apnea has grown for two reasons. First, Americans are getting less sleep. “In 2005, the National Sleep Foundation stated that 16% of Americans say they sleep less than six hours a night, compared with 12% in 1998” (UCLA, 2016). The second reason there seems to be more people with sleep apnea is there are more professionals and facilities to help identify and treat all those sleepy people. Since its establishment in 1975, The American Academy of Sleep Medicine or “AASM has expanded membership to over 11,000 accredited member sleep centers and individual members, including physicians, scientists and other health care professionals” (AASM, About, 2016).

            From its initial diagnosis in 1981, sleep apnea has been a disease that is associated with overweight middle-aged men (Sullivan, Issa, Berthon-Jones, and Eves, 1981). Through extensive research, an alarming number of children and athletes have been identified to have the similar symptoms of the typical sleep apnea suffer. The recognized trend in tiredness and the identification of cognitive impairments such as Attention Deficit Hyperactivity Disorder or ADHD has led sleep scientist to connect sleep apnea to as many as 25% of children that have ADHD (ASAA, 2016). Additionally, many athletes in the NFL, NBA, and MLB have been identified with sleep apnea (George, Kab, & Levy, 2003; MacMullan, 2016; Russell, 2016).

            Most recently, Texas Ranger’s first baseman, Prince Fielder disclosed his struggles with sleep apnea, and in 2015 Cleveland Indian’s Mike Napoli had surgery to cope with sleep apnea (Russell, 2016). Dr. Andrea Natale, a cardiologist, and consultant for the NBA, points out that because of their size, NBA players have a “genetic predisposition, [of] being overweight, sleep apnea and hypertension” (MacMullan,2016).

            There are many reasons children can have sleep apnea. They may have enlarged adenoids, swollen tonsils or they just may be large children. If your child is having trouble breathing while they sleep, talk to your pediatrician. It may be sleep apnea, or it may be:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse (AASM, Children,2016)

Symptoms of a sleep disorder in children may not be the same as in adults. As previously mentioned studies have indicated that as many as 25% of children with ADHD do show sleep disorder symptoms. The first step to proper control of a child’s sleep disorder is guidance from your doctor.

            For adults and children, the key to living with sleep apnea is early detection and after a diagnosis proactive management. If you think that you have a sleep disorder, I cannot say it enough, the first place to go is your doctor. After talking with my doctor about always feeling tired and loud snoring, his recommendation was to have a sleep study. Treatment of sleep disorders can offer some relief with other health conditions. In my case, after the sleep study, not only did I feel more rested, but over time, it helped me control my blood pressure and lose weight. I began managing my sleep apnea by using a continuous positive airway pressure machine or CPAP machine. The sleep lab I went to helped me with the fit and ongoing maintenance. Your doctor can best help you determine a solution for your sleep problem.

            Your doctor will probably recommend a sleep lab for your test. I did not go with my doctor’s recommendation at first. I thought I’d try to find a cheaper alternative closer to my home. It was like a cheap motel and a bad experience. I had to have the test redone and went with my doctor’s recommendations. The second location was much better. It was quieter; each room had a private restroom and the staff seemed to understand what needed to be done much better.

            If you have questions about finding a sleep lab, here are a few things to keep in mind. Ask if the sleep clinic has accreditation from the American Academy of Sleep Medicine? The standards that the AASM requires of members seems to make a difference. To me, it seems to be the gold standard of sleep labs. Check to see if the sleep clinic you are considering is in your health insurance network, it will make a big difference in cost. Ask if they offer patient education, follow-ups as well as on-going monitoring. Also a point I felt was very important, will they allow you to visit their clinic.

            About every three to six months you will need to replace part of your CPAP machine. It makes a difference in fit and hygiene. A leaky mask will allow you to snore and you lose the benefits of the CPAP machine. If you are using a dental appliance, regularly check with your dentist.

            Losing weight can help you to manage your sleep apnea too. Talk to your family members. If they notice you snoring through the mask or still continuing to gasp for air as you sleep, contact your sleep technician for further help.

            For many people, having a sleep disorder does affect the ability to obtain life insurance. I have addressed the growing problem of children who have sleep disorders. In addressing life insurance, this is not an encouragement to get life insurance for a child. People do not need to have a significant amount of life insurance on their children. There is no reason. However, a small amount of life insurance is always a prudent step. In most cases, this can be easily and cheaply accomplished by adding what is called a rider on to an adult life insurance policy.

            For those who are looking for life insurance, finding a life insurance company that is willing to consider active sleep disorder management as a positive attribute in considering you for a life insurance policy is important. There are life insurance companies that will look at your sleep disorder as an incurable disease and will deny you a life insurance policy. It is important to avoid a denial if at all possible because when you apply for other life or disability insurance, there will be a question that asks if you have ever been declined coverage for any reason. If you have to answer, yes that can cause a problem with the application. You do not want to lie; you want to avoid having the insurance denial altogether.

            The best way to prevent a denial is to submit an informal inquiry. An informal inquiry is where we take all of your health history information and anonymously submit that to several life insurance companies. Without disclosing who you are the life insurance companies will look at your circumstance and tell us if they are willing to consider a person with your health history. Also, they will say what they expect the cost will be. You can take advantage of the best offer that is made. This process gets you the best life insurance policy at the best possible price without having to bounce between life insurance companies. It is also the best way to avoid a denial for sleep apnea. Could you still be denied? Yes. This is not a foolproof process. However, if we can completely answer all of the questions up front and there are no unexpected circumstances, it is your best chance. It is the best process because you are getting the benefit of shopping many different life insurance companies at the same time.

            If you have health concerns, you will need guidance in the application process. I have been helping customers find life insurance coverage to protect their families for twenty-eight years. I’d be honored to begin helping you. The best way to begin is by completing the quote request form on our website, or you can call, email or text too.

Thank you,

Van Richards

Get a quote now.

 

 

References

American Academy of Sleep Medicine. (n.d.). Sleep apnea overview and facts – sleep education. Retrieved from http://www.sleepeducation.org/essentials-in-sleep/sleep-apnea

American Academy of Sleep Medicine. (2016). About the AASM. Retrieved from http://www.aasmnet.org/aboutaasm.aspx

American Sleep Apnea Association. (2016). Children’s sleep apnea. Retrieved from http://www.sleepapnea.org/treat/childrens-sleep-apnea.html

George, C. F., Kab, V., & Levy, A. M. (2003). Increased prevalence of sleep-disordered breathing among professional football players. New England Journal of Medicine, 348(4), 367-368. doi:10.1056/nejm200301233480422

MacMullan, J. (2016, February 29). Larry bird will die young. just ask him. ESPN The Magazine. Retrieved from http://espn.go.com/nba/story/_/id/14712117/larry-bird-believes-nba-big-men-die-young-right

National Highway Traffic Safety Administration. (n.d.). Research on drowsy driving. Retrieved from http://www.nhtsa.gov/Driving+Safety/Drowsy+Driving

National Institutes of Health. (2011). 2011 nhi sleep disorders research plan (NIH Publication No. 11-7820). Retrieved from U.S. Department of Health and Human Services website: https://www.nhlbi.nih.gov/files/docs/resources/sleep/201101011NationalSleepDisordersResearchPlanDHHSPublication11-7820.pdf

Russell, J. (2016, March 11). Rangers slugger prince fielder diagnosed with ‘extreme’ sleep apnea. Washington Post. Retrieved from https://www.washingtonpost.com/news/early-lead/wp/2016/03/11/rangers-slugger-prince-fielder-disagnosed-with-extreme-sleep-apnea/

Sullivan CE, Issa FG, Berthon-Jones M, Eves L (April 1981). Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1 (8225): 862–5. doi:10.1016/S0140-6736(81)92140-1.

UCLA Sleep Disorders Center. (2016). Sleep medicine growth and trends. Retrieved May 8, 2016, from http://sleepcenter.ucla.edu/body.cfm?id=37

 

 

 

 

 

 

 

Curing Cancer

Is the answer to curing cancer in a “moonshot” research effort or changing our habits?

In his last State of the Union Address, President Obama appointed Vice President, Joe Biden to head the “moonshot” effort to cure cancer (Obama, 2016). Biden’s part in this effort is to help eliminate controversy and obstacles that may stand in the way of advancements to finding a cure. This is an effort that has bipartisan support. Cancer is such a widespread disease that most people’s lives have been touched in one way or another by it. However, is a cure possible? By stepping back and taking a broad view of the past efforts to heal people, the answer to curing cancer may involve more than most people expect.

           The earliest recorded efforts to treat cancer dates back to 3,000 B.C. Writings on Egyptian papyrus from that time “describes 8 cases of tumors or ulcers of the breast that were removed by cauterization with a tool called the fire drill” (ACS, 2014). Treatments have improved over the centuries, although the approach to treating cancer and many other diseases is the same as it was 3,000 years ago. People want a magic pill; they want to take a very complicated issue and reduce it to one simple answer.

          The problem with this reductionism attitude is that the human body and diseases that affect it are incredibly complicated. In many scientific studies, the tactic is to take one component and attempt to see how one factor affects the overall body and disease. This is generally how modern medicine works. If a person has a medical problem, there is a pill for that. High blood pressure, there is a pill for that. High cholesterol, there is a pill for that. To its credit reductionism in medicine has produced many advances that have improved and lengthened the life of the average person. The reductionism approach to research has been used in the search for a cure to cancer with some good results. However, cancer is still one of the major diseases throughout the world, especially in the United States. Perhaps it’s time to widen the scope of the approach to reducing the number of cancer cases. Any decrease in the number of cancer cases is a victory to some family.

          In research studies such as the Nurses’ Health Study, over a quarter million female nurses participated (Nurses’ Health Study, 2016). One of the goals was to determine if fat in the diet had a connection to breast cancer. After investing millions of dollars in research that began in 1970 and ran for decades, the study produced very little information that correlated fat intake to breast cancer. The study determined that “breast cancer risk does not rise with increased intakes of fat, meat, dairy or saturated fat” (Campbell, 2005). The research project had a significant number of factors that were analyzed and produced masses of information. However when addressing the results of how fat intake affected breast cancer, one of the lead researchers Dr. Meir Stampfer, stated: “this has been our greatest failure – that we have not learned more about what people can do to lower their risk” (Marchione, 2001). Perhaps, the answer to reducing the incidence of cancer may not be in the treatment of one factor such as fat, it may be in changing the dietary lifestyle of society.

          To get a good understanding of how dietary lifestyle affects people, compare two studies of very different dietary lifestyles. Participants in The Nurses’ Health Study are primarily women from the United States that consume animal protein as a part of their diet. In that study, changes in the types and level of fat had no noticeable effect on the development of breast cancer. The study did not attempt to show the impact of animal protein versus plant protein in the development of cancer.   The Cornell China Study is a study of lifestyle and diet of thousands of people in China that primarily consume a plant-based diet. The New York Times called The Cornell China Study the “Grand Prix of epidemiology” (Brody, 1990). They went further to explain “Sixty-five hundred Chinese have each contributed 367 facts about their eating and other habits that could ultimately help them and Americans preserve their health and prolong their lives” (Brody, 1990).

          The Cornell China Study was lead by Dr. T. Colin Campbell, Professor Emeritus of Nutritional Biochemistry at Cornell University. Dr. Campbell’s research found that diets with lower concentrations of protein had a lower incidence of cancer. Dr. Campbell said, “dietary protein proved to be so powerful in its effect that we could turn on and turn off cancer growth by changing the level consumed” (Campbell, 2005, p.6). The study got even more precise by showing that not all proteins promoted cancer growth. “Casein which makes up 87% of cow’s milk protein, promoted all stages of the cancer process” (Campbell,2005, p.6). In the study, plant protein had no effect on the growth of cancer at all.

          If Vice President Biden wants to lead the effort to cure cancer, his efforts would be more productive if he and the government put more resources into helping people understand how animal protein and plant protein affects the human body. Living in one of the richest countries in the world has lead to Americans having some of the worst dietary habits. The challenge for Vice President Biden is to change the dietary habits of an entire nation. The consumption of animal protein is an enormous part the American economy. Companies such as Tyson Foods, ConAgra, Kraft Foods, Smithfield Foods, and General Mills have billions of dollars in revenue and employee thousands and thousands of employees. Their primary products are animal based. Their presence in the economy is politically and legislatively entrenched.

          Americans have a growing appetite for meat which in part is based on the marketing efforts of the meat industry that is sponsored by the US Government. The average American eats 128 grams of meat per day (Daniel, 2011, p 578). The public perception is that eating beef is healthy because the United States Government promotes it. “The Beef Promotion and Research Act of 1985 directs the Secretary of Agriculture to implement a federal program to promote the marketing and consumption of beef” (Champoux, 2006, p.1108). The United States Department of Agriculture provides funds to assist with the general endorsement of beef consumption through a program referred to as a commodity checkoff program. A dollar from the sale of each head of cattle sold is a tax used for the promotion of beef consumption. The “Beef. It’s What’s for Dinner” (Champoux, 2006, p.1107) advertisement is a commodity checkoff advertisement campaign to promote beef as a healthy and versatile meal.

          The beef industry goes beyond advertising and creates its own research as propaganda. A study by the American Journal of Clinical Nutrition shows that a dinner with beef is healthier than the average healthy American diet (Roussell, 2011, p.1). This study shows that the average American meal has 287 milligrams of cholesterol as compared to a meal with lean beef at 168 milligrams of cholesterol (Roussell, 2011, p.3). The perception that the study is communicating is a 41% decrease in food cholesterol is good. The only problem with that logic is 168 milligrams of cholesterol is still greater than zero which is the level of cholesterol in a plant-based diet meal.

          Higher cholesterol leads to obesity. The American Institute for Cancer Research recent report estimates that 351 cancer cases a day are connected to obesity (AICR, 2016). That brings up the question of why a research study would try to sway readers to think that beef is healthy. The study was funded by the government subsidized Beef Checkoff Program, which is a part of the Cattlemen’s Beef Board and National Cattlemen’s Beef Association, a group that co-sponsors the “Beef. It’s What’s for Dinner” (Champoux, 2006, p.1107) advertising campaign. The American Journal of Clinical Nutrition study is biased because it was funded by the Beef Checkoff Program to promote the sale of beef.

          To be fair, almost all commodities in the United States have a check off program. For example, the “cotton, the fabric of our lives” (ACPI, n.d.) advertisement campaign is a commodity checkoff program. Programs like the beef, dairy, pork, poultry checkoff programs are the strongest and most heavily funded.

          Vice President Biden is supposed to lead the Nation to find a cure for cancer. Would he and the Nation consider anything less than an absolute cure a failure? Would a 20%, a 40% or even a 60% reduction in cancer be a success? Yes, any decrease in the incidence of cancer would be a success. A decline in the number of cancer cases diagnosed would mean more sons, daughters, mothers and fathers that would live longer healthier lives. Perhaps we need Meatless Monday, Tofu Tuesday, Watermelon Wednesday, Tomato Thursday, Frijoles’ Fridays, Soy Saturday and Salsa Sunday. For those that can accept the facts of the research, the answer to drastically reducing the incidence of cancer is the elimination of animal protein from their diet. Yet it may be unreasonable to expect everyone to change their dietary habits suddenly. Perhaps, with education and an understanding that changes in “dietary protein […] could turn on and turn off cancer growth” (Campbell, 2005, p.6) will help people begin to eat healthier and, reduce the incidence of cancer. It might not be the magic pill society is in search of; however it will help many people avoid cancer and live longer lives.

References

American Cancer Society. (2014). The history of cancer. Retrieved from        http://www.cancer.org/acs/groups/cid/documents/webcontent/002048-pdf.pdf

American Cotton Producers and Importers. (n.d.). Cotton, the fabric of our lives. Retrieved from https://thefabricofourlives.com/our-programs

American Institute for Cancer Research. (2016). New estimates: obesity, overweight a cause of 351 cancer cases a day. Retrieved from http://www.aicr.org/cancer-research-update/2016/02_24/cru_New_Estimates_Obesity_Overweight_a-cause_351_Cancer_Cases_a_Day.html#.Vs_JbG8Y38k.linkedin

Brody, J. E. (1990, May 8). Huge study of diet indicts fat and meat. New York Times. Retrieved from http://www.nytimes.com/1990/05/08/science/huge-study-of-diet-indicts-fat-and-meat.html

Campbell, T. C., & Campbell, T. M. (2005). The China study: the most comprehensive study of nutrition ever conducted and the startling implications for diet, weight loss and long-term health. Dallas, TX: BenBella Books.

Champoux, M. (2006). Uncovering coherence in compelled subsidy of speech doctrine : Johanns v. Livestock Marketing Ass’n, 125 S. Ct. 2055. Harvard Journal OfLaw & Public Policy, vol. 29(3), pp. 1107-1108.

Daniel C.R., Cross, A.J., Koebnick, C, and Sinha, R. (2011). Trends in meat consumption in the USA. Public Health Nutrition, 14, pp 578. doi:10.1017/S1368980010002077.

Marchione, M. (2001, July 16). Taking the long view. Milwaukee Journal Sentinel, p. 2G.

Nurses’ Health Study. (2016). Our story – nurses’ health study. Retrieved from Harvard School of Public Health and Brigham and Women’s Hospital website: http://www.nhs3.org/index.php/our-story

Obama, B.H. (2016), State of the Union Address, Retrieved from The White House Website: https://www.whitehouse.gov/sotu

Roussell, M. A., Hill, A. M., Gaugler, T. L., West, S. G., Vanden Heuvel, J. P., Alaupovic, P., Gillies, P. J. (2011). Beef in an optimal lean diet study: effects on lipids, lipoproteins, and apolipoproteins. American Journal of Clinical Nutrition. doi: 10.3945/ajcn.111.016261

How much of a student loan is too much?

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—   College is an expensive challenge and many parents must share the expense with their child. Choosing a major is more important now than ever. If a college graduate goes into a career that has an annual income that is less than the total amount of their student loan, the loan will be an extreme burden on their life for years. A $45,000 income job with a $50,000 student loan is a big problem. Paying back a $50,000 loan at 6% over ten years is about $600 per month.   The Institute for College Access & Success provides a comprehensive state-by-state list of college students’ average debt. The average public college debt per student in Texas is $26,250 (TICAS, 2014). The TICAS website does not list many of the private college’s average student debt, and that is probably because private colleges are so expensive.   U.S. News & World Report list private colleges with the highest per student debt close to or above $50,000 at graduation (Snider, 2015 Feb. 17).

Disability and life insurance are crucial for parents and college graduates that are responsible for loans. If parents have taken on or co-signed student loan debt, it is important to consider increasing their insurance.   A two-parent family, going into retirement with one or more student’s loan debt can be a burden in the event of the death or disability of a spouse. If the new college graduate has taken on student loan debt, it is important for them to consider the burden it could place on their family in the event of their death. It is difficult for a 20-some-year-old to worry about life insurance. None-the-less, life insurance is cheap at that age. What should be more of a concern is not being able to work. Being disabled and not being able to pay student loan payments is a higher possibility than dying (SSA, 2011). A college graduate in their 20’s has a 1-in-4 chance of being disabled (SSA, Pub. 05-10570). Permanent disability is possible; however consider that having two broken legs from a snowboarding accident is a disability too. Not just any disability insurance will suffice for a college graduate trying to protect their income. The definition of disability is essential. Disability insurance that will pay if the graduate cannot perform the substantial duties of the job that they have the education and training to perform is critical. A disability insurance policy with the same definition of disability as Social Security would not be a wise choice (SSA, Pub. 64-030). Click below to

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References

Snider, S. (2015, February 17). 10 colleges that leave graduates with the most student loan debt. U.S. News & World Report. Retrieved from http://www.usnews.com/education/best-colleges/the-short-list-college/articles/2015/02/17/10-colleges-that-leave-graduates-with-the-most-student-loan-debt

Social Security Administration. (2011). Actuarial life table. Retrieved from https://www.ssa.gov/oact/STATS/table4c6.html

Social Security Administration. (2015). The facts about social security’s disability program (05-10570). Retrieved from https://www.socialsecurity.gov/disabilityfacts/materials/pdf/factsheet.pdf

Social Security Administration. (2015). 2015 red book (64-030). Retrieved from https://www.ssa.gov/redbook/documents/TheRedBook2015.pdf

The Institute For College Access and Success. (2014). State by state data. Retrieved from http://ticas.org/posd/map-state-data-2015#

What do Andrew Carnegie & William Wrigley, Jr. have in common?

 

They were both in a business round table.  The modern day round table is synonymous with the first mastermind group, called the Big 6, which Andrew Carnegie, William Wrigley, Jr. and four other Chicago business executives began in the 1920’s. The combined income of these six executives was estimated at $25 million dollars in 1920.[1] In 2015 dollars, that would be about $310 million dollars per year! Forbes magazine says “Masterminds are incredible and can do wonders for your business as well as for you”.[2] An important key to the success of a business round table is establishing an ongoing format and starting the first meeting with details of what is to come. Well run business round tables have a very successful history.

Prior to the first meeting it’s important for all participants to have an understanding of what the group is about and what expectations they should have of the group. At the first meeting and anytime a new member joins the group; they should give a little information about themselves and that of their company. Each member should come prepared to discuss three things:

  1. Where do you need help?
  2. Bring a resource to share.
  3. Share an idea that is currently working for you and your company.

The question of where you need help is up to the member. Business issues at times intertwine with personal issues so members should be free to choose the topic for their time to speak. It’s important to remember that this is not a time to solicit other members. An acceptable exception is if the member wants to go over a sales presentation and get members’ feedback. Examples of topics to bring up to the round table are new product ideas, marketing campaigns, technical issues, legal questions, accounting questions, web design or any other issue that will help the members be more successful in running their business. Sharing a resource could be as simple as sharing with the group a new Smartphone app that helps them in their business. Sharing an idea that is currently working could be anything that your company is doing that is particularly successful.  The time each member has will be determined prior to the meeting and depend on the number of members in the meeting. The time to speak could be anywhere in-between 8 and 20 minutes. Each participant should conclude their time to talk with a short summary on what they are hoping to accomplish by the next meeting and be prepared to let the group know how those plans went at the next meeting.

Expect email communication in between meetings. The members should arrange to acquire a summary of the topics discussed and the goals for the next meeting for each member. They should also expect to be contacted prior to the next meeting to check in.

Establishing ground rules from the outset is important to the continued success of the group. Meetings must start on time, have specific time limits for each member to speak and end on time. One member should be responsible for keeping time. Where, when and how long each meeting is should be a consensus of the group.  Keeping the format and rules simple will help the meetings to run smoothly. The most important rules of the group are no negativity and all information discussed within the group is confidential.

Business round tables may have a lifecycle; they have a purpose and will not last forever. Keep these steps in mind for continued success:

  1. The group is a democracy.
  2. Know your role and don’t dominate the group.
  3. Keep good meeting manners.
  4. Maintain a repeatable structure.
  5. Respect time.
  6. Stay focused.
  7. Keep goals.
  8. Be disciplined.
  9. Know when the group’s usefulness has been fulfilled.

For more information about the CyFair Executive Round Table send an email to van@cyfairexecutiveroundtable.com

[1] Vitale, Joe, and Bill Hibbler. “Getting Started.” Meet & Grow Rich. Hoboken: John Wiley& Sons, 2006. 39. Print.

[2] Burns, Stephanie. “7 Reasons To Join A Mastermind Group.” Forbes 21 Oct. 2013. Web

Seven steps to lower your out of pocket medical cost.

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When you are sick or injured and need to use your insurance, understanding the benefits and out of pocket cost can be very frustrating.  There are so many people involved in the medical care process that it is easy to become overwhelmed.  Here are seven simple steps to help you navigate the care and payment process.

1. Is your doctor still in your network?

Every time you go to your doctor, the first question is “has your insurance changed?”   When you set your appointment, you should ask if your doctor still accepts your insurance plan.

2. Is the lab your doctor uses in your network?

Most doctor visits will involve some sort of lab test.  Check with your insurance carrier to see if they have a preferred laboratory facility.  This can save you hundreds of dollars.  If your doctor takes specimens in their office, ask which lab they use.  If it’s it not a preferred lab with your insurance carrier, request that a preferred lab be used.  Laboratory costs are not usually covered by office charges.  Know before you go to save a lot of money.

3. Are you getting the best prices on medications? 

Pharmacy cost is one of the most significant expenses to medical care.  However most people don’t inquire about the medication cost unless they are paying the actual price of the medication.  It is worth your time to find the lowest price for a medication.  Controlling your cost will not only benefit you now, but it will help keep the cost down on your health insurance plan in the future.    One of the best sources for finding the lowest cost prescription drugs in your area is www.goodrx.com  There is an app available for this service as well.

4. If you need imaging test (MRI, X-ray, CT, etc) are you shopping?

The price difference for imaging is astounding, as much as 100% difference from one location to the next.  If location is important to you and you have time, scout out the location on Google maps.  Most locations will offer a street view with the map.

5. If you need outpatient or inpatient procedure is the surgery center in network?

Doctors work at a variety of different centers for surgery.  After speaking with the doctors representative for payment arrangements, it is important to contact the surgery center and inquire about their network status.

6. Is the anesthesiologist in the network?

Your doctor or the surgery center will be able to tell you who the anesthesiologist is and help you determine if they are in our network or not.  Remember if they are out of your network, you are responsible for 100% of what your insurance carrier will not pay.  That cost difference may be substantial so it’s worth the extra effort to check.

7. Do you need to shop for durable medical equipment (crutches, slings, special recovery items such as a Cryo Cuff).

Many surgical procedures will require special durable medical equipment.  Most doctors require the patient to make arrangement and payment for durable medical equipment prior to surgery.  Two questions for the supply center is do they offer a network discount and will they allow equipment not used after the surgery to be returned and credited to your account.

Healthcare cost tends to follow the 80/20 rule.  Eighty percent of the cost of healthcare can be attributed to twenty percent of those that are insured.  So if you are in that twenty percent population that is using hospital care, it would be in your best interest to try to control your cost.  The seven steps listed could save you thousands of dollars and a lot of grief.

Should you be selling or buying now?

Wall Street a

Years ago I worked with a company that had a cold calling bull pen much like what you see in the in movies.  One of the managers would call clients and say “I have terrible news for you!”  And what followed was an effort to encourage the client to buy or sell.  After a period of time, I recognized that was not the place for me.  I learned a lot about people while at that company.   First, people are moved by fear.  In that time I met with an elderly client that had just lost $10,000 on her investment.  I was young and toting the company line.  I tried to explain why she had lost money and how everything would be OK.  She looked me square in the eyes and said have you ever lost $10,000?  I lived through that meeting to learn that investors have a justified concern to be afraid of investing.  People can and do lose money.  So should investing be avoided?  For some the answer would be yes, some people should not be investing in stock based investments.  But for a great number of people investing in stocks and bonds is still a good idea.

In the past month, stocks and oil have been losing value, so how can I say that investing is still a good idea?    Just as in life, there are no guarantees.  However, history has shown that over many years investing in stocks and bonds can outpace the cost of inflation and yield better results than a fixed account.  To wisely invest takes planning.  You don’t have to be a Wall Street wizard; you just have to employee simple strategies to protect yourself.  Here are five simple ideas that can help you reduce the volatility of investing.

  1. Know why you are investing: retirement, college savings, caring for a disabled child, etc.  My family loved to go to Disney.  We’d spend hours trying how to figure out how we could get the most out of the week we would spend in Orlando.  Most people spend more time planning for a weeklong vacation than they do for retirement that could last more than thirty years.  Make plans and review them every year.
  2.  If you are new to investing, choose a mutual fund.  Avoid single stocks for now.  In a nutshell, mutual funds are pools of stocks or bonds.  Some are professionally managed and some are not such as index funds.  How much you pay for your mutual funds or the fees charged is very important. Generally the level of fees should reflect the level of service you receive.  If you’re new to investing paying a little for advice might not be a bad idea.   If you’re not getting service or don’t need it, lower fees are better. Most mutual funds that are purchased through employer plans will have higher fees.  This does not make them bad.  Employer plans have many more maintenance requirements and sometimes cost more.
  3.  Diversify – don’t put all your eggs on one basket.  If you are going to diversify make certain you are not buying several of the same type of mutual fund.  I once had a client that had 28 different mutual funds.  Yes she was diversified, but half of the funds were similarly invested.  Aggressive individuals will have a larger percentage in stocks.  Conservative investors may have no money in stocks.  Still be cautious not to put all of your money into one type of fund.  If you think that bonds are safe, understand that if interest rates go up, bond values go down.  Determine your investment personality and let that guide you in choosing the percentage of money you invest between conservative and aggressive.  There are funds that will manage the allocation of your investment for you such as lifestyle funds or target funds.  It is your job to review these and see how well the fund is meeting your expectations.
  4.  Dollar cost averaging.  I often am asked “is now the best time to buy?”  I have no idea when the best time to buy is, so I suggest that people buy all the time.  Plans that invest or withdraw money on a monthly basis will give investors a tool that can help them better manage the risk of investing.  Imagine if you bought a stock at $12 and it went down a dollar each month for six months and then back up a dollar a month for the next six months (it ends at $11).  If you invested a hundred dollars a month, did you lose or gain? At the end of the twelve months your $1,200 would be worth $1,529. The average price was $9. This is a simplification, but the idea is you never know when the best time to buy is, so buy all the time.
  5.  Rebalancing is a simple concept that will take some volatility out of investing.  If you make gains over a period of years you will progressively be increasing the risk on your total mix of investments.  By rebalancing you stabilize or lower the risk of investing.  This is very helpful when there are large swings in stock prices over an extended time.

Investing is not a perfect science.  Make a plan and review it every year.  Turn-of-the-century American humorist Will Rogers had a saying that fits here very well.  “Even if you’re on the right track, you’ll get run over if you just sit there.”

Three Problems With Health Insurance For Employers & The Solution

Three problems with health insurance for employers & the solution

Three problems exist when it comes to renewing your company’s health insurance. The first problem is that renewal proposals are usually received very close to the renewal deadline allowing little time for analysis. The second problem is that benefits continue to be reduced to avoid premium increases. And the most significant problem to employees is that when all else fails, employers pass the increased cost on to the employees.

Employers put a great deal of time and effort into changing their complete benefit plans, changing pharmacy benefit managers, changing the amount they pay of the employee and dependent cost. Many of the changes are only temporary. The same process has to occur prior to the next renewal every year.

The key to reducing the cost of large group healthcare plans is identifying what is driving the cost from company to company. What drives cost for the oil and gas industry is different than what drives cost for wholesale and retail companies. Oil and Gas companies tend to have richer plan designs to compete for technical employees. Wholesale and retail employers tend to have more unmarried workers that result in fewer dependents. To remain competitive, it is vital that employers first know how their benefits and cost compare to their peers. If your costs are not competitive, find out why. Cost differences within an industry sector can be due to items such as plan design, level of dependents covered or the cost of illness within a group.

The renewal process should be more than a once a year decision. Employee utilizations should be continually monitored and reviewed by executive brief throughout the year. Trends can be identified and decisions become an ongoing informed process rather than a last minute decision. This process solves the first problem. At ABS our account executives conduct new employee meetings monthly, reports are reviewed regularly with key employer staff and decisions begin to be formulated six and three months prior to the formal renewal date of the healthcare plan.

Two key drivers across all industry sectors continue to be pharmacy cost and hospital cost. The state that has done the best at controlling hospital cost is Maryland. The State of Maryland has implemented an “all-payer rate setting system” for hospitals. Controlling pharmacy and hospital cost in Texas and other states can be done in a similar manner by indexing the true cost to a benchmark such as Medicare. In this benchmarking process a reasonable profit margin is negotiated with the pharmacy benefit manager and the hospital service provider. By using a system like this, the State of Maryland has the acquired the lowest hospital rates in the United States. According to the Institute for Health & Socio-Economic Policy Maryland has an Average Charge to Cost Ratio of 140.18%. Compare that to Texas which has an Average Charge to Cost Ratio of 398.31%.

Lower cost solves the second and third problems mentioned above. Lower cost results in a stable level of benefits and employers are not forced to increase rates for employees. Stable cost mitigates a great deal of tension between employer and employee. A stable healthcare plan goes a long way in creating a better work life balance for employees.

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