How many more renewal increases, deductible adjustments, or narrow network offerings till you decide enough is enough⁉️
Continue reading AAA – Solution To High Cost Ambulance Service?
AAA – Solution To High Cost Ambulance Service?
Month: June 2022
Canadian Prescription Drugs Provide Savings For Health Plans
ATTENTION EMPLOYERS: Do you have anyone in your health plan who is costing big dollars due to high-cost prescription drugs? The same drug may be significantly less expensive in Canada.
MEDSAVE MANAGEMENT LLC assists self-funded plan sponsors towards obtaining Canadian prescription drugs for plan members.
Continue reading Canadian Prescription Drugs Provide Savings For Health Plans
American Hospital Association Issues Fact Sheet on Reference Based Pricing
Some employers are moving away from offering traditional coverage with a provider network and instead are using reference-based pricing for some or all of services they cover.
Continue reading American Hospital Association Issues Fact Sheet on Reference Based Pricing
States Move Ahead With Canadian Drug Importation
What did the cat say when the train ran over it’s tail?”
Continue reading States Move Ahead With Canadian Drug Importation
Boiled Alive
Article Referred By Brent Evans
There was once a frog who had been captured by his country and put in a cage. As he was a very scared and naive frog, he believed it when told it was for his own good.
Canadian Prescription Drug Importation Program
How it Works
- We select a Canadian pharmaceutical manufacturer and negotiate with the manufacturer and the seller.
- Rx is imported to the United States where we test and relabel the product, transport it to a warehouse, and store it securely.
- Your state agency orders the Rx from us, and we prepare, ship, and deliver the order.
Continue reading Canadian Prescription Drug Importation Program
Employers May Have To Pay More in 2022
Employers may have to pay more in 2022. but here’s a solution………
For plan years beginning in 2022, coverage is considered affordable if an employee’s required contribution for self-only coverage does not exceed 9.61% of the employee’s household income.
Blue Cross: You Can Check Out Anytime You Like But You Can Never Leave
https://youtu.be/UehilhnMt5Y?t=253
The Bottom Line: Brokers earn bonuses, vacations to keep companies from switching from Blue Cross
Continue reading Blue Cross: You Can Check Out Anytime You Like But You Can Never Leave
Lawyers Have Field Day With Dobbs vs Jackson
Put two lawyers in a room and they will come out with three different opinions………….
Continue reading Lawyers Have Field Day With Dobbs vs Jackson
Does Your Rx Plan Cover RU-486?
RU-48 was developed in 1980 and came into use in France in 1987. It became available in the United States in 2000. It is on the World Health Organization’s List of Essential Medicines.
TRS ActiveCare Touts “FREE” Specialty Drug Benefit
Feel-good email brings great news for plan members but threatens plan finances…..
Continue reading TRS ActiveCare Touts “FREE” Specialty Drug Benefit
New York State Set To Enter Medical Tourism Business
New York Announces Special Medical Tourism Package Designed For Pregnant People…………
Continue reading New York State Set To Enter Medical Tourism Business
Buying Down An Aggregate Corridor
Realizing the decision to purchase will be based on worst case scenario, a broker can deliver the lowest bid every time if he knows how.
Send This Man To Rehab! Will Insurance Cover It?
We need to know if he’s high. Has he been doing bong hits, blasting rails, chasing the dragon, and/or dropping acid? Is he hopped up on goofballs?
Continue reading Send This Man To Rehab! Will Insurance Cover It?
Former Insurance Worker Becomes A Mermaid
“The former insurance company worker described the experience of gliding under water, half-human and half-fish, as “meditation in motion.”
Governor Says “Who, Me?”
Who, Me? Nope I Didn’t Do It!
New Jersey Governor says he didn’t intervene in insurer dispute
Cash Pay Health Plans Make Sense
Cash Pay Level Funded Plan Make Sense
Combining level-funded plans with locked-in cash-pay rates for medical procedures purchased prior to treatment creates an innovative cost containment network strategy for employers.
Amarillo Drug Dealer Makes It Big
Amarillo Drug Dealer Earns Billions
Little did anyone imagine a drug dealer in West Texas (you can’t get there from here) would turn into a billion dollar business. It all started with a $21,000 loan from a loving mother.
Watch This Case Study Webinar
“Please take the time to watch this compelling case study webinar that showcases what is possible when an employer takes a truly proactive approach to controlling the cost of healthcare claims” – Dan Meylan
Texas Based Study On NSA Arbitration Cases Raises Questions
Texas-based study raises questions about impact of using additional criteria in No Surprises Act arbitration cases
Continue reading Texas Based Study On NSA Arbitration Cases Raises Questions
Weird Insurance Company Names Cropping Up Everywhere!
Gun Bill Includes Extension Allowing Kickbacks to Insurer’s PBMs
SOURCE: Howard A Green, MD – Linkedin
Can’t make this shit up. US Congress sneaks into the current gun bill an extension allowing continued kickbacks to insurers pharmaceutical benefit managers screwing patients and their physicians.
Continue reading Gun Bill Includes Extension Allowing Kickbacks to Insurer’s PBMs
Lawyers Get Sued Too
Lawyers Professional Liability Insurance
Zurich’s Lawyers Professional Liability Insurance Program offers Professional Liability/Errors and Omissions coverage to the following segments of attorneys: Law firms with attorney count of up to 100 attorneys; solo attorneys; part time attorneys and moonlighting attorneys.
Davita Stock Price Plummets – 10k Report Reveals Fears
Davita Locations
Certain payors have been attempting to design and implement plans by limiting the number of in-network providers, setting arbitrary provider reimbursement rates,……….
Continue reading Davita Stock Price Plummets – 10k Report Reveals Fears
Dialysis Limited Benefits Doesn’t Violate Medicare Secondary Payer Statute
“The question in this case is whether a group health plan that provides limited benefits for outpatient dialysis — but does so uniformly for all plan participants — violates the Medicare Secondary Payer statute. We agree with petitioner Marietta and the United States as amicus curiae that the answer is no.
Continue reading Dialysis Limited Benefits Doesn’t Violate Medicare Secondary Payer Statute
Bankrupt Status-Quo Health Plan Eyes Cost-Shifting Remedies
“There is no excuse for this! Poor risk management, old style remedies and believing in magic is a recipe for disaster!” – Don Pedro
Continue reading Bankrupt Status-Quo Health Plan Eyes Cost-Shifting Remedies
Cassie Brown
Insurance Commissioner Cassie Brown
Cassie Brown was appointed to serve as Texas insurance commissioner by Governor Greg Abbott in September 2021. She is the chief executive of the Texas Department of Insurance (TDI), overseeing the regulation of the third largest insurance market in the nation and the eighth largest in the world. The agency regulates approximately 2,800 companies and more than 700,000 agents and adjusters.
100 Million People in U.S. Saddled With Health Care Debt
6 in 10 working-age adults with coverage have gone into debt getting care in the past five years, a rate only slightly lower than the uninsured.
Continue reading 100 Million People in U.S. Saddled With Health Care Debt
PBMs Could Be Driving Up Plan Sponsors’ Drug Costs
In June 2016, only two months after the contract term began, an individual’s claim for an erectile dysfunction compound medication totaled $405,325.43 over three months Continue reading PBMs Could Be Driving Up Plan Sponsors’ Drug Costs
Proposal to Import Drugs Creates Unusual Alliance in the Senate
By Victoria Knight
Harmony is not often found between two of the most boisterous senators on Capitol Hill, Bernie Sanders (I-Vt.) and Rand… Read More
Continue reading Proposal to Import Drugs Creates Unusual Alliance in the Senate
Bill Smart
https://youtu.be/iP9CzgHVv78
William Jackson Smart was a twice-married, twice-widowed Civil War veteran and father of 14 children……….
Summer Session 2022
A Public Purchasing Seminar – June 22, 23, 24, 2022 – Designed for Public Purchasing Professionals with special emphasis on the latest developments that are essential in public purchasing.
Free Hospital Care For The Uninsured!
Attorney General Bonta Issues Consumer Alert Following Reports of Hospitals Failing to Inform Patients of Options for Free or Reduced-Price Medical Care
“Only dumb people pay for health insurance in California” – Molly Mulebriar
5 Steps to Providing Better Employee Health Coverage: $0 Premium, $0 Copay, $0 Deductible
“Great turnout at TASB Summer Leadership Institute in San Antonio! My presentation was standing room only and about 20 Board Members were listening from the hallway. I’m excited to see so many districts ready to join this movement. Thousands more school employees will have access to affordable health coverage next year.” – Ben Clinton
Goose Insurance – Historic Change in Product Distribution
“Our current system of distribution through independent agents in their brick-and-mortar offices will be largely replaced with digital distribution channels like Goose and Lemonade Insurance startups. That’s the future and the future is now” – Bill Rusteberg
Continue reading Goose Insurance – Historic Change in Product Distribution
Attention Plan Sponsors – Stake Your Claim To $485 Million Rx Settlement
Ranbaxy exploited the FDA’s “abbreviated new drug applications” (ANDAs) in order to secure valuable first-to-file generic status and lucrative 180-day exclusivity that comes with the first-to-file status.
Continue reading Attention Plan Sponsors – Stake Your Claim To $485 Million Rx Settlement
New Sales Opportunity For California P&C Agents
How many Californians have guns? Whatever that number is, a proposed government mandate requiring liability insurance will bring fast and easy bucks to aspiring P&C agents. “George, you own a gun?” is the opening line sales pitch……………”Then you have to buy this policy or go to jail!” is the closing line………………”Sign here!”
Continue reading New Sales Opportunity For California P&C Agents
AMPS Offers Solutions For Hospital Sponsored Health Plans
Advanced Medical Pricing Solutions (AMPS) offers the consultancy experience, external contacts and integrated solutions you need to make it possible…………..
Continue reading AMPS Offers Solutions For Hospital Sponsored Health Plans
Texas Shuts Down Unlicensed Insurer – 65,000 Policyholders Affected
TDI orders unlicensed insurer, Salvasen Health, to wind down operations in Texas
The Texas Department of Insurance (TDI) issued a consent order (PDF) today requiring Houston-based operation Salvasen Health to stop selling unauthorized health insurance and begin an orderly shutdown.
Continue reading Texas Shuts Down Unlicensed Insurer – 65,000 Policyholders Affected
Does Free Cafeteria Plan Administration Constitute Rebating?
Cafeteria Plan Administrators offering “Free” administration services in return for selling insurance products earn commissions on insurance policies sold to plan members. Nothing wrong with that, sounds like a good deal. But are there any regulatory issues?
Continue reading Does Free Cafeteria Plan Administration Constitute Rebating?
Employers – It’s Time To Help Hospitals Achieve Their Charitable Mission!
Give Me Your Poor, Your Tired, Your Huddled Employee Masses…………..You may be surprised by how many of your employees are eligible for free hospital care!
Continue reading Employers – It’s Time To Help Hospitals Achieve Their Charitable Mission!
Clueless City Struggles With Health Care Costs
KEY TAKEAWAYS:
- Top two rated insurance consultants replaced with the bottom two ranked consultants proving it pays to be last
Continue reading Clueless City Struggles With Health Care Costs
Texas MedClinic Acquired By Community Health Partners
Dr. Bernard Swift, founder and CEO of Texas MedClinic
Texas MedClinic sold to larger private equity-backed network. The company announced the sale of 20 urgent care clinics to national operator Community Care Partners.
Continue reading Texas MedClinic Acquired By Community Health Partners
Go Farther Gasoline
A tankful of Go Farther Gasoline would sure go a long way towards easing the pain at the pump these days…………………..
Hospitals Fined The Equivalent of Two Hospital Admissions
“Don’t worry, it’s only a scratch. We’ll make it up on the next one or two hospital admissions”
Continue reading Hospitals Fined The Equivalent of Two Hospital Admissions
U.S. LawShield – Legal Defense Protection for Gun Owners
Texas Man Wins Arms Salesman of The Year
There is no other arms salesman on the entire planet even close to what this Gun Salesman of The Year has achieved! He has sold more guns in less time than anyone else in history. His secret sauce? Reverse psychology selling – “Hell, yes, we’re going to take your AR-15, your AK-47…..”
Continue reading U.S. LawShield – Legal Defense Protection for Gun Owners
Tesla Insurance
Community Care Partners
Community Care Partners is a physician owned and managed group of urgent care and primary care clinics serving patients across the United States under the brands Nova Health, SouthStar, Coastal and BestMed Urgent Care.
Yottaflow Offers Instant Online Stop Loss Quotes
MyHealthGuide Source: Yottaflow, 6/7/2022
CLEVELAND — Yottaflow is excited to announce brokers and TPAs can now obtain illustrative stop loss quotes instantly from Yottaflow’s quoting partners.
Continue reading Yottaflow Offers Instant Online Stop Loss Quotes
Aldeen’s Sunday Morning Bathroom Read
By Doug Aldeen, Attorney at Law
Lawyers are the fourth branch of government: If you cannot legislate or regulate it, litigate it.
Geico To Pay $5,000,000 For Car Sex?
Car insurer Geico may have to pay $5m after woman contracts STI in a vehicle………..
Howden Acquires TigerRisk
Howden acquires TigerRisk, creating “much-needed” fourth global reinsurance broker
Everything You Need To Know About Writing Professional Liability Insurance in 30 Minutes
Any business that gives advice needs professional liability coverage including insurance agents and consultants active in health care…………………..
What Does The Future of Healthcare Look Like?
The world of medicine is changing faster than ever, with new treatments and technologies being discovered all the time. The Medicine 2042 conference, taking place between June 8-9 in Tel Aviv envisions the future of medicine and science, and what that might look like in the year 2042 and beyond.
Continue reading What Does The Future of Healthcare Look Like?
Pay Your Hospital Bill with Salt Water
“You have provided me with a surprise medical bill. I am providing you a surprise medical payment …………..”
Wholesale Brokerage Expands Texas Footprint
The MGU unit acts as an underwriting manager for various insurance companies for which it primarily underwrites ICOA insurance, Texas Non-Subscriber and related insurance products.
Continue reading Wholesale Brokerage Expands Texas Footprint
I Don’t Have Time To Choose The Right Vendor!
Shortlister – An HR vendor selection community that helps empowered, data-driven technology buyers to find and choose the right vendor.
Continue reading I Don’t Have Time To Choose The Right Vendor!
Dostarlimab
18 rectal cancer patients were given dostarlimab every three weeks for six months and ended up cancer-free………………………….“I believe this is the first time this has happened in the history of cancer………”
Another Virtual Healthcare Offering Hits Market
Benefits include unlimited virtual visits with $0 copay and $0 deductibles, capacity to treat over 1,500 conditions, the ability to prescribe medications and write orders for labs, x-rays and other diagnostic tests………………….Dedicated physician, $1 drugs………….
Continue reading Another Virtual Healthcare Offering Hits Market
Backstory On This Whole Rx Rebate Fandango
As Scott Haas says, the term rebate is meaningless because it can mean whatever the PBM wants it to mean……………..
Amber’s Homeowners Insurance Policy To The Rescue?
“While legal experts say using homeowner’s insurance policies is common in defamation cases, Virginia lawyer Jeremiah Denton told The Post that most policies have a clause that stipulates judgment costs will not be covered.”
Continue reading Amber’s Homeowners Insurance Policy To The Rescue?
Obamacare Premiums Set to Spike By 53%
“What turned the Joker into Joker was losing his government-subsidized mental health care. His whole life went to shit because the government made him dependent and then pulled the rug out from under him.”
Radion Health
A 400 life case can be underwritten without claims experience or individual health questions? That’s interesting………….Is experience rating becoming a thing of the past? Continue reading Radion Health
We Want Your Stop Loss Business
Web based real time on-line final rates, immediate firm quotes, no participating requirements, quote down to 10 lives……………………level funding made easy
State Farm Email Solicits Agents For “Unique Project”
“On January 18, 2022, State Farm sent an email recruiting its agents for a “unique project”. Consumers’ Research obtained a copy of that email, and we knew we had a duty to alert the public.”
Continue reading State Farm Email Solicits Agents For “Unique Project”
The $1,000,000 Vitori Victory© Guarantee
Meet the Vitori Victory© Guarantee, the first of its kind. This health plan savings guarantee will reimburse you up to $1,000,000 if we don’t hit your savings target.*