Archive for June, 2021

Sandra Can’t Be Happy

Wednesday, June 30th, 2021

Sandra Fluke Reacts To Outrageous Viagra Price Hike

“Outrageous. I fought for free birth control and now this! Our men are entitled to free viagra!

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Walmart Launches Low-priced Insulin

Wednesday, June 30th, 2021

For years, patients, consumer advocates and U.S. lawmakers have complained about the high list prices for insulin and the significant out-of-pocket costs borne by patients.

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The Slow Death of Private Practices

Wednesday, June 30th, 2021

The days when a doctor could show up in a small town, rent an office and hang out a shingle, sadly, is pretty much over. The knowledge base necessary to run a small business is not part of medical education, and few new graduates want to tackle such a task.

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State Auditor McGuiness Demands $24.5M in Overcharges Back From State Employees’ PBM, Express Scripts

Monday, June 28th, 2021

PBM Swamp Creature Stunned By Demand

Delaware paid three times the average drug inflationary price between 2018 and 2020 for state employee prescriptions………………

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Water Street 2020 Annual Review

Monday, June 28th, 2021

Over the past four years, we have built a leading group of employer health services companies healthcare costs while providing a seamless, positive experience to employees.

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Monday, June 28th, 2021

If you have clients with 1.) An annual insurance spend greater than $1,000,000 2.) A good loss history, I have a program that will save them 25%-50% on premiums while not cutting your commission.

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Sonja, You’ve Been Smoking Some Bad Weed!

Monday, June 28th, 2021

In one of his first acts as president, Joe Biden directed his agencies to review …………. a system called ICRHA – that would sever the traditional bonds of trust between an employer and its employees.

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Drug Barrons Build Walls & Traps

Monday, June 28th, 2021

“Hey Luigi, how’s that wall coming”

Dominant drug manufacturers use rebates to keep lower-priced drugs off the market……..

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RBP Vendor Embraces PPO Strategy

Sunday, June 27th, 2021

A case of Wanting His Cake and Eat It too……..A half pregnant attempt towards solving health care……………….

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Federal Appeals Court Revives Dummy-code Lawsuit

Sunday, June 27th, 2021

“Evidence included correspondence showing Aetna literally told Optum to “bury” its fees by using a dummy code…..”

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Court Finds Cross Plan Offsetting A Prohibited Transaction

Friday, June 25th, 2021

The insurer’s use of a pooled bank account also suggested an ERISA prohibited transaction because it made Plan A’s interests adverse to those of Plan B……………

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Where Were The Math Teachers?

Friday, June 25th, 2021

Teachers demanded more money in order to spend more money on….. (drum roll please)….. HEALTH INSURANCE.

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Centivo acquires assets from Apostrophe, Inc.

Friday, June 25th, 2021

Buffalo, NY, June 23, 2021 – Centivo, a health plan for self-funded employers anchored around leading providers of value-based care, announced today that it has acquired certain assets, including select client and healthcare provider relationships and intellectual property, from Apostrophe Inc., a Denver-based health benefits platform and third-party administrator, effective immediately.

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Ramos vs Banner Health

Wednesday, June 23rd, 2021

Tenth Circuit Makes Clear That Arms-Length Service Agreements Without Evidence of a Prior Relationship Are Not Prohibited Transactions

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Second PBM Reform Bill Becomes Law in Texas

Wednesday, June 23rd, 2021

Second PBM Reform Bill Becomes Law in Texas

“Texas HB 1919 became law last week. The bill prevents PBM self-dealing by prohibiting them from steering patients to affiliated pharmacies. It is the second PBM reform bill to become enacted recently in Texas.”  MORE >>

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Why Was News of India’s Success With Ivermectin Suppressed?

Tuesday, June 22nd, 2021

I have grown more cynical as this Pandemic became politicized. Therefore this sentence is even more alarming…

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TPA Demands NDA (or else!)

Tuesday, June 22nd, 2021

Our compliance team has been auditing our records and it was identified that we do not have an NDA for you.  (So?)

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Texas School Districts Face Decision Deadline

Monday, June 21st, 2021

Texas school districts have until December 2021 to make a decision they haven’t had to make in the past 20 years. Do they stay with the TRS ActiveCare government health plan or do they choose coverage in the commercial market?

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Why I No Longer Believe Gov’t Health Care Can Work

Monday, June 21st, 2021

Barack Reacts To Article

“I Was a Physician at a Federally Qualified Health Center. Here’s Why I No Longer Believe Government Health Care Can Work.” – Rebekah Bernard M.D.

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School District Alert: Beware of Health Insurance Cooperatives

Sunday, June 20th, 2021

Dozens of school districts left scrambling to pay $11.6 million in debts, a financial shipwreck that raises concerns about such ventures, which are virtually unregulated……

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FAKE NEWS: Cheap Insurance

Sunday, June 20th, 2021

More than one million individuals chose a health plan that has a monthly premium of $10 or less….

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How America’s Top Hospitals Pound patients With Predatory Billing

Wednesday, June 16th, 2021

A new analysis reveals that many of the top hospitals in America pursue patients with lawsuits and other predatory billing practices

How America’s top hospitals send patient costs soaring (axios.com)

Individual Health Insurance vs Group Insurance

Wednesday, June 16th, 2021

Adios Group Insurance 

“Instead of employers purchasing insurance plans on their employees’ behalf, they should give their employees pre-tax cash in an HRA, with which employees can purchase ACA-compliant plans”

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Easy Decision

Tuesday, June 15th, 2021

Why would a school district stay with a failing government health plan, be held hostage for five years, have no control over plan benefits or rates when they can access the open market with some very good options that guarantees market rates, better benefits, guarantee issue with pre-existing conditions covered immediately?

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Employer Can Demand Vaccination As A Job Requirement

Monday, June 14th, 2021

“You must be vaccinated against (insert name of disease here) or lose your job!”

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CPO’s Beat PPO’s Everytime

Monday, June 14th, 2021

Several of our clients have established cash pay centric health plans with good success. Plan savings are similar if not better that what one can expect from a RBP plan and it is certainly much better than a PPO plan.

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Golden Parachute For Texas School Districts?

Sunday, June 13th, 2021

One of the best kept secrets few are aware of is a golden nugget imbedded in the Texas Insurance Code…………………..

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Hurry, The Bus Is Leaving The Station!

Friday, June 11th, 2021

Bus driver Ms. Katrina Daniels smiles as her bus fills up for a five year bus ride to Less Choice, Texas.

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Why Your Health Care is Tied To Your Job

Friday, June 11th, 2021

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How Much Do You Charge?

Thursday, June 10th, 2021

“Your Fees Are Too Damn High!”

By Bill Rusteberg

Early in my presentation yesterday I was asked “How much do you charge?”

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New Blood Test Detects More Than 50 Types of Cancer

Wednesday, June 9th, 2021

Blood test could reduce 5-year cancer mortality by about 40%……………

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2022-2023 Health Insurance Options For Texas Public School Districts

Tuesday, June 8th, 2021

With the passage of Senate Bill 1444 (SB 1444) Texas public school districts may elect to exit the TRS ActiveCare (TRSAC) program effective September 1, 2022.

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The Reasons Why Most Texas Public Schools Will Stay With TRS ActiveCare

Saturday, June 5th, 2021

Back in 2001, right as the Texas legislature passed TRS ActiveCare, I visited with a Superintendent of a district we had insured with Mutual of Omaha.

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TRS ActiveCare 2021-2022 Renewal Presentation

Friday, June 4th, 2021

April 3, 2021

TRS ActiveCare officials met to finalize the TRS ActiveCare 2021-2022 plan year.

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Texas School Districts Face Tough Insurance Decisions

Thursday, June 3rd, 2021

Nostradamus’s December 2021 Prediction

By Bill Rusteberg

For the first time in over 20 years TRS ActiveCare member districts have the freedom to exit the program and seek coverage through the commercial market. What are they going to do?

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TRS ActiveCare Renewal 2021-2022 Summary

Thursday, June 3rd, 2021

Rates & Benefits- 8% rate increase – 7% benefit reduction in High Deductible Plan only

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El Paso ISD’s $18,000,000 Health Plan Deficit

Wednesday, June 2nd, 2021

El Paso ISD’s TRS ActiveCare Alternative Plan has successfully established a record $18,000,000 health plan deficit without even trying.

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El Paso ISD Proposes 2021-2022 Health Insurance Budget

Tuesday, June 1st, 2021

September 2021 will be the start of EPISD’s second renewal cycle since adopting a TRS ActiveCare Alternative program. How accurate were the underwriter’s financial projections?

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Offshore Insurance Scheme Helps American Home Buyers

Tuesday, June 1st, 2021

Insurance scheme plays critical role in making home ownership possible for many Americans . “It eases the burden of down payments and provides a fast track to buying property. Without it, many citizens would have to wait years to save up to purchase their own home.”

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