Archive for May, 2021

School Board Leader Sentenced in Corruption Scheme

Monday, May 31st, 2021
FOR IMMEDIATE RELEASE
Wednesday, May 26, 2021

BROWNSVILLE, Texas – The former vice president of the Brownsville Independent School District (BISD) Board of Trustees has been ordered to federal prison following her convictions of conspiracy and corruption, announced Acting U.S. Attorney Jennifer B. Lowery.

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No Claim Experience? No Health Questionaires? No Problem!

Monday, May 31st, 2021

Something that has been a long time coming for us at Verikai is almost here! In just a few short weeks the Marketplace will be live, but you can sign up for free TODAY!

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“Texas Teachers Have Better Health Insurance Options Than TRS”

Monday, May 31st, 2021

TRS ActiveCare will eventually become a de facto high risk pool unless officials incorporate fundamental changes. 

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TRS ActiveCare Board To Meet 3 June 2021

Sunday, May 30th, 2021

Some districts are back in the Wiggle Room while others are standing in government holding cells waiting to serve a mandatory 5 year sentence without the possibility of parole…..

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Memorial Day 2021

Friday, May 28th, 2021

Lt. Col. E. Rusteberg – West Point 1934 – Two Silver Stars, One Bronze Star, Presidential Unit Citation (Battle of Hatten), Purple Heart. 

The battalion began the battle of Hatten with 33 officers and 748 en- listed men. Fifty-two hours later it had an effective strength of 11 officers and 253 enlisted men. All others were either killed, wounded or missing in action.

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MedSave Major Medical Model

Friday, May 28th, 2021

Purpose

A comprehensive employer sponsored medical plan removing most financial barriers to health care at unit costs significantly lower that traditional health care plans.

Benefits

No member financial responsibility if Plan rules are followed. Members who do not follow the rules are subject to $3,000 front end Plan year deductible, 50% co-insurance up to the maximum allowable under the Affordable Care Act (ACA).

Structure

DPC, Cash Pay Centric, Reference Based Pricing wrap, Specific Stop Loss (in-patient charges only), Specialty Drug risk transfer, Self-funded, Excess Cover, Catastrophic condition risk transfer.

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27 December, 2021

Thursday, May 27th, 2021

Beginning Dec 27, 2021, brokers and consultants to group health plans will be required to disclose their compensation…………….

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TRS ActiveCare Board of Trustees To Meet

Wednesday, May 26th, 2021
TRS Board of Trustees meeting is scheduled for Thursday, June 3, 2021 at which time it is expected Plan year 2021-2022 rates will be made public.

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FPL Risk Transfer Strategy

Tuesday, May 25th, 2021

When I described the strategy to a fellow insurance consultant he asked “Bill, this is very interesting, when did you learn about this?” “About 24 hours ago” I responded.

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Oh Boy, Now What Do We Do Now?

Monday, May 24th, 2021

It’s now or never and it’s only you………………………..

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Doc In A Box

Monday, May 24th, 2021

Step inside and be cured. No appointment necessary. The waiting room may be somewhat crowded so don’t forget to wear a mask.

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The Cost of Convenience

Friday, May 21st, 2021

“More employers are seeing the value of adding a little bit of inconvenience to their health plans these days.

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Risk Tolerance & Reference Based Pricing Strategies

Friday, May 21st, 2021

The problem I see with most health insurance consultants is almost all pre-determine a client’s tolerance for risk before determining where the risk tolerance actually lies.

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AMA Has Plan For Racial Justice in Medicine

Friday, May 21st, 2021

AMA states one goal as “ensuring just representation” of persons of color in medical school admissions, medical schools, and hospital leadership.

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How Much Was Your Ticket?

Thursday, May 20th, 2021

Imagine next time you board a flight to Muleshoe Wyoming. You settle in comfortably, the plane takes off and all is good.

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Brokers Should Know How To “Field Underwrite”

Wednesday, May 19th, 2021

Making things simple can save a whole lot of time for everyone. Cost, as always, is a factor in any purchase.

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Allstate Facing Lawsuit From Agent’s Group

Wednesday, May 19th, 2021

In its lawsuit, the NAPAA and several former agents allege that Allstate interfered with potential sales of agents’ book of business, which collectively cost them millions…….

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Guaranteed No Balance Billing!

Wednesday, May 19th, 2021

Some RBP vendors are killing it!

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Attention Yacht Brokers

Wednesday, May 19th, 2021

Calling all P&C and Surplus Lines licensed producers! We insure vessels across the Caribbean Sea, Europe, Mexico, certain U.S. states and Latin America.

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Government Price Control or Free Market Health Care?

Monday, May 17th, 2021

“As Congress and states consider ways to address affordability, they should consider policies that address the underlying cost problem—the high prices being charged by providers—and extend those to the employer market. One possible approach is capping prices based on a percentage of Medicare rates.”

Why do we need government to mandate price controls? Plan sponsors can simply pay whatever they deem appropriate and providers can accept or reject the offer. That’s called free market and it works. More and more employers are doing this with good success. The rest remain on the managed care plantation – Bill Rusteberg

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How the ICHRA is Changing the Face of Health Benefits

Sunday, May 16th, 2021

More than 800,000 employers and 11 million employees are projected to participate in an ICHRA over the next few years………………….

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Underwriters Are People Too

Sunday, May 16th, 2021

Do underwriting manuals include a “bias” factor calculation?

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Why Would An Employer Not Do This?

Saturday, May 15th, 2021

Goodbye, complex health benefits. Hello, simple!

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Talking Out Of Both Sides of The Mouth Is An Art Form In Austin

Saturday, May 15th, 2021

Austin legislators say they support competition to allow TRS ActiveCare member districts to obtain their claim experience from the state in order to seek competitive commercial alternatives. At the same time they vote to end the District of Innovation loophole that allows member districts to seek and obtain competitive commercial alternatives. Then they add a Poison Pill making it almost impossible for member districts to leave the TRS government health plan.

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Lowering Medicare Eligibility To Age 55

Saturday, May 15th, 2021

Lowering Medicare eligibility to age 55 will have a significant impact of health care financing in this country. Turbocharged cost shifting to commercial health plans will spur into action those employers still sitting on the managed care fence and give Reference Based Pricing strategies new life…………..

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Texas Legislation Favors Government Health Plan

Friday, May 14th, 2021

In a blow to commercial health insurance plan providers, it appears likely SB 1444 will pass giving the TRS ActiveCare government health plan a virtual monopoly.

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The $167,249.79 Dream

Friday, May 14th, 2021

Mary, a 56 year old working mother has a bad back. Her doctor recommended surgery. As she lay unconscious on the operating table little did Mary know the man in a mask lurking behind the surgeon was dreaming of a big payday.

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Karnak The Magnificent Nails It Again

Wednesday, May 12th, 2021

ICHRA, I……C…..H…..R…..A, ICHRA!

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Underwriting Dental Plans Is Not Rocket Science

Tuesday, May 11th, 2021

“It’s Elementary My Dear Watson”

Employers who fully insure their dental plans should consider a self-funded approach instead. Savings in premium taxes, insurance company retention charges, agent commissions can be as high as 25% and more. The following will give the reader a good understanding of underwriting pricing.

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Sell Insurance While You Sleep

Monday, May 10th, 2021

Insurance Broker Hard At Work

Selling insurance has never been easier…………………..at least that’s the message in an unsolicited email we received today (we get lots of these kinds of emails). 

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Ivermectin – Miracle Cure For The Chinese Flu?

Sunday, May 9th, 2021

The common antiparasitic ivermectin is being touted as a miracle cure for COVID-19 by doctors and campaigners the world over…………….


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Government Requires You Pay Full Billed Charges Whatever They May Be

Sunday, May 9th, 2021

“The CARES Act requires insurers to pay the full billed charge to the provider. Unless they’ve negotiated, their hands are tied.”

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Centivo Launches New Health Plan

Saturday, May 8th, 2021

Self-funded employers can now offer an affordable health plan to their employees with no deductible, no coinsurance, free primary care……………

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U.S. Healthcare Needs To Stop Preying On its People

Saturday, May 8th, 2021

Brian Klepper

America should resist solutions that require even more money to pay for the current system. Instead, it should establish a process that methodically gets U.S. healthcare back to a system that serves rather than preys on its people.

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Underwriting Made Easier

Saturday, May 8th, 2021

Accurately evaluating groups looking to transition from fully insured to self-funded benefit plans can be a financially risky endeavor, particularly with little, or no, recent claims data to evaluate………………

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Diarrhea Pandemic Kills 525,000 Children

Friday, May 7th, 2021

Student Ponders Fate – Teachers Demand School Closure

“Precisely 54 children in the Land of the Free have died from COVID (according to CDC data through April 28)”. However “Diarrhea kills around 525,000 children under five every year.” Yet did anyone ever close the schools to prevent the spread of the diarrhea-causing rotavirus? Children Are Far More Likely To Die From Diarrhea Than COVID-19.

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Legislative Exhaustion in Austin

Friday, May 7th, 2021

I read the latest version of SB1444 this morning (which I suspect will pass) and noticed a change: Regional Education Service Centers to be required to oversee a survey of districts in their service area. Section C is interesting:

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The Best Teacher Ever

Friday, May 7th, 2021

The following story is an amazing story of a fourth grader who was lucky to get an exceptional teacher at a pivotal time in his life.

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Joe Solves Health Care

Thursday, May 6th, 2021

Joe is from deep South Texas. He started a small company a few years back with only a handful of employees. Through his leadership he grew the business into what it is today. But it’s not the company brand that drives recognition, it’s what Joe has done to control health care costs for his valued employees that catches the spotlight.

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WTF Is This Bull Shit!

Thursday, May 6th, 2021

The Departments (DOL, HHS and Treasury) Require Plans To Show Their Work ASAP!

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The Value of Health Care Networks

Thursday, May 6th, 2021

Networks “could” be a solution to rising healthcare costs, but at this current moment, they are the problem. 

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George Carlin Warned Us

Tuesday, May 4th, 2021

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And The Winner Is………………..

Tuesday, May 4th, 2021

Delaware’s Supreme Court rejected without elaboration on Monday Cigna Corp.’s bid for a $1.85 billion deal termination fee tied to the collapse of its $54 billion merger with Anthem Inc. in 2017.

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Health Insurance Too Cheap To Ignore

Tuesday, May 4th, 2021

If you are uninsured because health coverage seemed too expensive the last time you looked, it’s time to look again.

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Nurse, I’m Back!

Tuesday, May 4th, 2021

Hyper-Vaccinated Airline Pilot on Break

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High-Value Health Care: A Model for the Future

Monday, May 3rd, 2021

Batman Slaps Down Status Quo Broker

Dramatic changes to the status quo are necessary in order to create a health care system that is universally high in quality, affordable and egalitarian.

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Another Bite Of The Apple – HB4078

Monday, May 3rd, 2021

Relating to participation in and rates for coverage provided under the uniform group coverage program for active school employees. HEARING SET FOR MAY 5

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Israeli Company Develops New Technology – Destroys Cancer Tumors

Sunday, May 2nd, 2021

Israeli company develops new technology that can destroy cancerous tumors……

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How Much Should We Pay Hospitals Boss?

Saturday, May 1st, 2021

CFO: Boss, what should our self-funded health plan pay hospitals?

CEO: “Authoritative research shows that Medicare plus 25 percent is the reasonable amount for hospitals to charge….” 

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Employers Fed Up With Insurance Companies

Saturday, May 1st, 2021

Any employer who relies on payer contracts they can’t see has got to be dumb…….

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