Dental insurance giant Delta Dental of California is facing mounting criticism for paying its CEO exorbitantly, flying board members and their companions to Barbados for a meeting……

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“I’ve never heard anyone rob a bank so they can get to prison so they could get health care,” James Griffin, the assistant district attorney prosecuting Gallagher……………..

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Health Insurance Agent Reacts to News

Raging Left Coast Democrat vows to eliminate all private health care insurance for approximately 150 million Americans………………………………….

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A small team of Israeli scientists think they might have found the first complete cure for cancer…….

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The Brownsville Independent School District (BISD) in deep South Texas is seeking an insurance consultant in a competitive request for proposal process.

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A new group wants to raise $2.5 million to fight State Treasurer Dale Folwell’s plan to reduce health care spending for about 720,000 state employees and retirees…………….

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Superintendent used her own health insurance to seek medical treatment for a sick student…….

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Investment positions Payer Compass to continue its rapid growth………to date the company has grown to serve over 125 payer customers, representing nearly 1,000 employer groups and over two million covered lives………………….

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We were excited to be featured on the CBS Evening News and CBS This Morning earlier this week!

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As the support for a single-payer, “Medicare-for-All” health care system in U.S. grows, so do the contributions from the health insurance industry………………

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Poll: 56 percent of public supports ‘Medicare for all’

BY PETER SULLIVAN – 01/23/19

A majority of the public supports a single-payer health insurance system, often called “Medicare for all,” as the idea gains steam among Democrats, according to a new poll.

The poll from the Kaiser Family Foundation finds that 56 percent of the public supports a single-payer plan, compared to 42 percent who oppose the idea.

Progressives are pushing the new Democratic House majority to move forward on the idea, and many Democratic presidential hopefuls have signed on to the idea as well. More centrist Democratic lawmakers remain opposed to the proposal, however.

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The State of North Carolina’s Reference Based Pricing sweet spot is 177% of Medicare. “The new rates for various categories of services will average out to 177% of Medicare’s fees, down from a current (PPO) average of 213%, North Carolina Treasurer Dale Folwell (R) told The Wall Street Journal. …………………………”

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This 35 minute podcast is well worth the time………….Listen to the Master, David Contorno…..

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Wellness Consultants Cheech & Chong

Attention HR Directors! Take your Wellness Program to a high & reap the rewards of a happy and mellow workforce! 

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“Brokers are also seeing high demand for benefits communication, employee engagement and transparency as a way to address the rising cost of healthcare…..” REALLY? How in the world will this reduce health care costs?

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“The primary villain in the multi-year erosion of the value of the employer-provided health benefit, and private insurance generally, has been drug costs.”

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“The court strongly hinted that the practice violated ERISA’s fiduciary duty rules, including the requirement that plan assets of one plan be used for the ‘exclusive purpose’ of benefiting individuals covered by that plan.”

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A RETIRED TEXAS SUPERINTENDENT ON WHY TEACHERS ARE QUITTING IN DROVES: “UPS starts people with no experience (HS diploma or GED) at $13 per hour plus full benefits. Within a couple of years you can graduate to a route where drivers make six figures after five years. In 7 years you can make over $100k delivering packages. In contrast, my wife is in her 25th year as a teacher with a Masters degree. She makes $57k and has some of the worst insurance in the country”

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Answer: Pay Less For Health Care………………………………..

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As Reference Based Pricing (RBP) strategies take hold in the market, with more vendors entering the fray for market share, the inevitability of increasing competition becomes evident. That is good news for plan sponsors……………………

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“Find help from experts—do not use a general benefits consultant—this is tricky stuff!” That is a true statement. Most general benefits consultants don’t know squat about the PBM world and simply make recommendations off spreadsheets. “This one is the best because they are offering AWP-28%!”

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January 14, 2019

By Brian Klepper

It seems inevitable that, in the near future, an innovative health care organization is going to seize the market opportunity, gradually cobble all the pieces together, and demonstrate to organizational purchasers that it consistently delivers better health outcomes at significantly lower cost than has previously been available.

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“The goals of this investigation are to determine why drug companies are increasing prices so dramatically, how drug companies are using the proceeds, and what steps can be taken to reduce prescription drug prices.”

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The following article can be summed up as follows: Changing from a Defined Benefit Plan to a Defined Contribution Plan saves money…………………….

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The majority of recoupments are taken at the expense of self-insured plans to the benefit of fully-insured plans………………..

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“There is “sobering evidence” that the level of price transparency is actually getting worse…….

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Most group health insurance plans have a 30, 60, or 90 waiting period before coverage starts. We know of one that has an even longer waiting period…………..

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The master of reason and logic explains……………………..

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It pays to shop for health care. A $40,000 drug for 1/10th of that……………..This broker is worth her weight in gold. Is yours?

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WELCOME TO OUR MODERN HOSPITAL WHERE IF YOU WANT TO KNOW A PRICE YOU CAN GO FUCK YOURSELF……………………………….

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Employers of any size may offer HRAs to reimburse employees for the cost of their premiums for individual health insurance coverage…………….

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“We’ve got 9 million taxpayers and 720,000 participants in this plan who understand that they aren’t consuming health care, it’s consuming them.” — Dale Folwell, N.C. Treasurer

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Houston Independent School District is in financial hot water. There are many reasons for this. One is the Robin Hood effect wherein HISD must transfer local taxpayer money to the state for re-distribution to poorer school districts. Another is the rising cost of health care, Houston ISD’s second largest budget item. 

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This story also reflects some of the challenges faced by rural hospitals everywhere……………

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“We are extremely proud of the success Payer Compass has achieved to date as we have grown the company to serve over 125 payer customers, representing nearly 1,000 employer groups and over two million covered lives.”  –  Greg Everett

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Question: How do we know we are doing better (saving money) this year than last year?

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They are running out of money…………………………………

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The end objective is a better health care delivery model with an alignment of “enlightened self-interests” and a balance between rewards and value for the employer, employee, and provider……..

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Confessions of a Reformed Health Insurance Broker – From Innocence To Darkness

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Oh, this makes sense! Everyone knows what 1100000003 is. Last time I had a 1100000003 was last year and my insurance paid only $1,654 for almost a 50% discount. Oh-My-Gosh, 1100000027 looks really competitive………! I’m going to Christus Health next time!

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