LINCOLNSHIRE, Ill., March 6, 2014 /PRNewswire/ – As employers search for new and innovative ways to provide competitive benefits to employees, positive second year enrollment results from Aon Hewitt, the global talent, retirement and health business of Aon plc (NYSE: AON), demonstrate that the Aon Active Health Exchange is delivering on its promise to engage consumers, offer broad choice and control cost.
Aon Hewit: Private Health Exchange Mitigates Costs, Engages Consumers
March 6th, 2014Out-of-Network Provider Charges 6,200% of Medicare
March 6th, 2014
“……a physician billed a patient $115,625 for lumbar spinal fusion – 62 times the Medicare fee of $1,867“…………..
“Take It To The Limit” – Accurately Identifying and Taking Advantage of Network Contractual Boundaries
March 6th, 2014
While it is true that some network contracts restrict a benefit plan’s ability to audit claims – or as is more often the case, simply prohibits the benefit plan from doing anything with the information so identified; some contracts apply unrealistic deadlines and still others contractually compel payment of claims otherwise excluded by the plan document… There are key provisions plan administrators can use to limit or eliminate the negative impact of such provisions.
Join The Phia Group’s CEO – Adam V. Russo; Sr. Vice President – Ron E. Peck; and select members of their legal team as they address some of the most common conflicts experienced by plan administrators utilizing a preferred provider organization network, action you can take now to avoid conflicts, and strategies you can apply to maximize the benefit of network usage.
Thursday – March 27th 1:00 – 2:00 PM EST To Register Now, Click Here
https://www.youtube.com/watch?v=FbxdGW82xx4
Sharp Growth In Private Exchanges Predicted – Moodys
March 5th, 2014
“The big potential growth of private exchanges is not going unnoticed by major benefit consulting firms, who are investing “significant funds and management resources” to develop their exchanges, according to the report.”
Goal Of Underwriting Stop Loss – Drain Value, Avoid Claims
March 5th, 2014
“The stop loss insurance business is an underwriter’s game. Their game plan is to avoid paying claims. They screen each prospect with claim review and disclosure requirements, and reject or rate-up anyone who may actually present a claim. The higher the deductible, the more effective this process, hence the bias to drive deductibles higher and higher. The carriers who have done best in this business have been the ones with average higher deductibles for this reason.”
Berkshire Hathaway Specialty Offers Health Care Umbrella Policy
March 5th, 2014March 4, 2014
Berkshire Hathaway Specialty Insurance, a unit of Berkshire Hathaway Inc., has launched a health care umbrella policy.The form is designed to address the exposures of large medical providers, the Boston-based insurer said in a statement Monday. The policy provides a definition of “insured” that includes new entities acquired or created by the named insured and provides business crisis and reputation protection benefits, according to the statement. The policy’s contractual liability coverage section addresses accountable care organizations, the insurer said.“From its flexible, modular format to the absence of a hammer clause in claims, the form embodies our commitment to collaborating with health care providers to most effectively manage risk,” Robert Romeo, vice president of health care and construction claims at BHSI, said in the statement.
Brownsville ISD Insurance Meeting – Will MAA Be Sued Next?
March 4th, 2014
Suing a ham sandwich has never been easier!
“…………..its been several years without payments (to medical providers) …………….we think they will be happy……………………..” ( Homer G. Farnsworth, M.D. says “Oh really? Is it not possible these medical caregivers have a legal right to full billed charges since payment is overdue past required time limits under Texas statue?”)
The first 6 minutes of this video is pretty interesting – http://bisd-kbsd-itv.pegcentral.com/player.php?video=8079ed9dab491a7cfb1ce697296b2a00
The remaining 25 or so minutes are also interesting for those in the insurance business. For example, a pre-paid legal plan with rates guaranteed for 6 years?
State Bar of Texas Implements Private Exchange
March 2nd, 2014
The Texas Bar Private Insurance Exchange is a multi-carrier private exchange designed for State Bar of Texas members and their staff and dependents. Available to both individuals and employer groups, the exchange offers a wide range of health insurance choices and more. https://texasbar.memberbenefits.com/
Edgewood Independent School District & Cost Plus Insurance
February 28th, 2014
CLEVELAND, OHIO - NCN News: Molly Mulebriar’s investigative team ,disguised as school teachers, has spent the past several weeks working undercover investigating the Edgewood ISD’s recent move from Blue Cross Blue Shield fully-insured health insurance program to a self-funded Cost Plus Insurance scheme.
Edgewood ISD is a San Antonio area public school district.
Homer G. Farnsworth, M.D., senior spokesman for the Mulebriar organization (www.mollymulebriar.org ) said a Mulebriar Special Report will be released early next week.
Corruption in Brownsville ISD? – “Insurance contracts, employee voluntary group insurance, insurance consultant………….”
February 26th, 2014
By Sergio Chapa
Brownsville ISD is the Rio Grande Valley’s largest school district but according to a new federal lawsuit, it may also be the most troubled. A 29-page page lawsuit filed at Brownsville’s federal courthouse on Tuesday outlines at least three year’s worth of corruption: http://www.valleycentral.com/uploadedfiles/kgbt/news/stories/catylawsuit.pdf
The “tell-all” lawsuit alleges acts of favoritism and corruption at Brownsville ISD. Among the allegations are favoritism with school district contracts and retaliation against those who asked questions. BISD school board members Luci Longoria and Caty Presas are suing the school district they were elected to represent. The two are also suing Superintendent Carl Montoya, school district attorney Baltazar Salazar and their fellow board members.
Presas and Longoria claim late school board president Enrique Escobedo ( http://www.valleymorningstar.com/news/local_news/article_14138370-6900-11e3-b3d9-0019bb30f31a.html) acted as a ringleader of the corruption. They claim Escobedo had a personal relationship with Joe Salazar, a person whose company got a contract for insurance at the district ( http://salazarinsurancegroup.com/about/). The lawsuit also alleges that Escobedo gave his own brother school district work. Presas and Longoria claim Port of Brownsville board member Martin Arambula gave escobedo’s brother a $3 million dollar contract.
A short time later, Arambula got a raise at his job at BISD while his sister got a school district contract awarded to her company.
Presas and longoria claim school board members retaliated against them for asking questions. The two said claim they were shut out of committees and other school board activities.
Action 4 News tried to speak to both sides of the lawsuit but neither wanted to commented due to the pending litigation.
A court date for the lawsuit has been set before U.S. District Court Judge Andrew Hanen in Brownsville on April 29th.