It’s hard to keep secrets in the insurance industry but in this instance the TEE Mystery Insurance Program wins the 2023 Best Kept Secret Award. As a GCISD board member recently stated during a TEE presentation, “If you are scared to answer my questions then that right there is a big red flag.”Continue reading Education Insurance & Risk Management Program
Founded only 12 years ago, Optum now employs 10% of all American physicians. Optum is a United HealthCare company. Imagine, 90,000 doctors working for an insurance company! Who’d ever thought!Continue reading 12 Year Old Company Now Employs 10% of All American Physicians
When he left Manchester United to join Real Madrid in 2006, Ferdinand’s United and England teammate David Beckham covered himself at Lloyd’s with a £100 million policy.Continue reading David Beckham’s Leg & Face Insurance
Within the last few weeks, something big has happened: two public independent school districts in Texas have begun the journey to separate from the Texas Association of School Boards (TASB) and become official partners with the state’s first true alternative service provider, Texans for Excellence in Education (TEE).Continue reading Rebellion Brews Among Texas School Districts
South of the line (USA) prescription drugs are more expensive than those purchased north of the line (CANADA).Continue reading The Economic Impact Of A Line On A Map
More Americans are turning to individual health insurance policies because for many of them the government is paying for most of it.
“For many of the almost 50 million people working for the 3.2 million smaller companies in America, family coverage is no longer affordable.Continue reading 50 Million People Can’t Afford Group Health Insurance
“I can eat all I want because my employer covers Ozympic and Wygovy!”
“At their November meeting, the SEBC noted weight loss medication coverage as a large contributing factor to the deficit.”Continue reading State Health Plan Blames Weight Loss Medication On Budget Deficit
Double network revenue turbocharges profits for the non-profits?
“In recent years, BCBS plans opened medical clinics that exclusively serve their members. Premera Blue Cross partnered with Seattle-based Kinwell Medical Group in 2022 to open primary care clinics for its members in Washington state.”Continue reading The Blues Open Medical Clinics Across The Fruited Plains
By Marshall Allen
I recently got an interesting email from the clinic manager at a private psychiatry office. She has been reading Never Pay the First Bill and wanted to allow her insured patients to pay cash when the cash price was lower than their insurance company discounts. But she worried her insurance company contracts prevented it.Continue reading Clinic Manager Advises Patients When Cash Price Is Cheaper Than Insurance Prices
The Edinburg Independent School District’s self-funded health plan is hemorrhaging. Plan costs have increased 100% over the past five years driven to a large extent by specialty drugs.Continue reading Edinburg ISD Canadian Rx Cost Analysis Illustrates Enormous Savings To Be Gained
The growing role of government in health care finance since 2010
By Tom Daly
Since its enactment in 2010, the Affordable Care Act (ACA) has undergone several significant changes. These alterations reflect efforts to adjust, improve, or challenge various aspects of the law.Continue reading Affordable Care Act 2010-2023
Ten states have uninsured rates below 5 percent. What are they doing right?
Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.
Universal health care remains an unrealized dream for the United States. But in some parts of the country, the dream has drawn closer to a reality in the 13 years since the Affordable Care Act passed.Continue reading The US Doesn’t Have Universal Health Care— But These States (almost) Do
By Dutch Rojas
In a bold move shaking up the corporate healthcare scene, many, that’s a lot, large companies are discarding traditional health insurance networks.Continue reading Why Does Your Self-Insured Health Plan Need A Network?
Expands current balance billing prohibitions to include ground ambulance services. Rather than applying the independent dispute resolution process, SB 2476 directs TDI to create an emergency service provider balance billing rate database. Health plans must reimburse ground ambulance services at:Continue reading Texas Senate Bill 2476 – Ground Ambulance Balance Billing
Moral hazard in health care is common. Here’s two examples:Continue reading Too Embarrassed To Ask?: What Is Moral Hazard?
A Christian Health Nonprofit Saddled Thousands With Debt as It Built a Family Empire Including a Pot Farm, a Bank and an Airline
Despite a history of fraud, one family has thrived in the regulatory no man’s land of health care sharing ministries, where insurance commissioners can’t investigate, federal agencies turn a blind eye and prosecutors reach paltry settlements.Continue reading How Liberty HealthShare Left Thousands With Debt as It Built a Family Empire
“Think about it: It is just like H&R Block “maximizing your tax refund”… except you and your family are headed to Disney courtesy of the local not for profit facility” – Doug AldeenContinue reading Aldeen’s Sunday Morning Bathroom Read
“It’s no longer viable to go it alone and administrative requirements from insurance companies are time-consuming and burdensome. That’s killing things. It’s just so incredibly complex” – Allen Ditto, M.D.Continue reading No One’s Promising You Can Keep Your Doctor Anymore
The American health care system is financed through for-profit insurers while a Bismarck health care system is not. American health care is racing towards a major upheaval and the BUCAs know it.Continue reading Are Non-Profit Health Insurance Companies The Future Of American Healthcare?
Where else can you get free or almost free health insurance these days? Third party intermediaries like HealthSherpa, Milliman, Nexben, Take Command Health and many others provide enrollment assistance to help make that happen……………Continue reading HealthSherpa Enrolls 2,430,000 Americans On FREE, or Almost Free Individual Health Insurance
Plan Sponsor Reacts To Lawsuit Brought By Employee Johnny Sixpak
“If you currently participate in [company name]’s Healthcare Plan, you may have a legal claim. Are you a current [company name] employee who has participated in the company’s healthcare plan? You may have a legal claim — and we’d like to speak with you. Contact our office today for a no-obligation, confidential consultation. At Schlichter Bogard, we protect whistleblowers.Continue reading Get Ready! Plan Members Will Be Receiving Emails Like This!
Selling health insurance is a tough business. It’s not a created sale, it’s a replacement sale which means relationships must be destroyed before any chance of a sale is possible. Destroying relationships takes time, effort and money.Continue reading Destroying Relationships For A Living
This reproduction of Lloyd’s Coffee House was put on display in the ’28 Building for the 1951 Festival of Britain.Continue reading Lloyds of London Revisited
An injury almost ended Nicole Kidman’s career because insurance became too expensive for her production company to cover.Continue reading Lloyds of London: Hollywood Insurance
A typical dental plan today is usually limited to $1,000 to $1,500 annual maximum. The government wants to treat dental care as an Essential Health Benefit with unlimited coverage.Continue reading Dentists Rejoice: Government Eyes Unlimited Dental Coverage For All
Sales is a profession like no other. Unlike most other professions, salesmen are paid exactly what their worth, nothing more and nothing less. Most are graduates of the School of Hard Knocks.Continue reading Great Salesman Don’t Need A Stinking MBA
Employers and unions are getting fed up with the firms they have used for years to help control their spending on prescription drugs—because their costs keep soaring.Continue reading Foot Locker, Teamsters Show Their Drug-Benefit Managers the Door
The Baskins-Robins “Pick Your Favorite Flavor” Approach To Health Care
By Ich Ra
Why not give your employees a choice of up to 86 different ACA approved plans through four (or more) different brand name insurance companies (instead of just one as you have now) while limiting your contributions to whatever your budget allows on a per employee per month basis?Continue reading Employers Have Up To 86 Reasons To Rejoice!
Below are the provider lookup links for each of the BUCAs:Continue reading BUCA Provider Network Lookup
Mark Cuban is taking on Big Pharma, in a quest to help employers lower drug costsContinue reading Mark Cuban Is Taking On Big Pharma
Watch the Ednburg Independent Insurance Committee learn (1) Their Rx spend is up 26.3% over last year, from $162.79 to $203.21 pepm, (2) International Rx sourcing could save over $600,000 on just one drug alone (Ozempic) and (3) Why Independent claim audits aren’t necessary because “Blue Cross audits every single claim.…..you’re only paying 29.6% of allowed charges.” NOTE: “Allowed Charges” are not billed charges.Continue reading School District Considers International Rx Sourcing & Independent Claim Audits
The Ben Feldman Cold Call Approach
Juan makes cold calling look easy. Here he demonstrates his unique cold calling approach to setting an appointment with a perfect stranger in less than 45 seconds.Continue reading Juan Demonstrates How To Nail An Appointment In Under 45 Seconds
Powered by $5M investment, startup Yuzu Health takes on insurers’ ‘brittle’ technology
By Noah Tong Nov 1, 2023
Entrepreneur Max Kauderer thinks the company he has co-founded, a third-party administrator called Yuzu Health, can disrupt major insurance companies by helping offer small businesses more affordable health plans for its employees.Continue reading Yuzu Health
Sec. 1501.009 of the TEXAS INSURANCE CODE stipulates an independent school district may elect to participate as a small employer without regard to the number of employees in the district.Continue reading Most Texas School Districts Don’t Know This
Warren says companies will save up to 20% on their Workers Compensation insurance by dealing direct with his insurance company. He says you can get a quote and get covered online in minutes.Continue reading Warren Touts Lower Cost Workers Compensation Insurance
By Bill Rusteberg
Want to escape punishing government oversight of your employee health plan? Want to reduce or eliminate your second largest company expense? Become a small employer and be happy.Continue reading The Power of Small In American Health Care Finance
Department of Labor Settles Cross-Plan Offsetting Case
Cross-plan offsetting refers to the practice by which a health plan insurer or TPA recoups alleged overpayments to a healthcare provider under one plan by reducing subsequent payments owed to the same provider or plan participants under a different plan.Continue reading Cross-Plan Offsetting: Robbing Peter To Pay Paul
Marpai Names Damien Lamendola as Chief Executive Officer to Drive the Next Phase of its Growth; Names Mike Dendy to BoardContinue reading Marpai Appoints Lamendola CEO, Dendy Joins Board
Article Referred by Mike Dendy
Many Americans are often overpaying for services when they use their insurance…….Why pay $2,400 when you can pay $541? More plan sponsors are adopting cash pay claim strategies……………Continue reading Texas & Tennessee Pass Legislation Turbocharging Cash Pay Claim Strategies
The New York State Volunteer Firefighter Enhanced Cancer Disability Benefits Act requires every fire department and company in the state of NY with eligible members must show proof of coverage.Continue reading New York State Requires Cancer Insurance For Vol. Firefighters
SALT LAKE CITY — PeopleKeep, the leader in personalized benefits for small and midsize organizations, released its third annual report on the individual coverage health reimbursement arrangement (ICHRA).Continue reading ICHRA Administrator Releases 3rd Annual Report
Resolve reviews and reduces medical bills on your behalf. We’ll lower your bills or our service is free. Guaranteed. – Start Lowering Your BillsContinue reading Lower Your Medical Bills With Resolve
In potential cancer breakthrough, newly found ‘kill switch’ triggers death of cancer cells: ‘One-two punch…………………..Continue reading Death Receptor’s Kill Switch Turns Cancer Cells Room Temperature
Self-serve CarePods use artificial intelligence to screen and diagnose health conditions
Replacing doctors with machines. Next thing you know they’ll be installing self-serve checkout kiosks at the grocery store and self-driving cars to get you there!Continue reading The Machine Will See You Now….
Fixed Benefit & Income Protection In Action: Doctors Visit – $120 Benefit, Chiropractic Visit – $120 Benefit, Specialist Visit – $150 BenefitContinue reading Revolt Healthcare
We at First Primary Care have been doing some never seen before things to help our broker/advisor partners achieve their mission to help deliver health benefits to their clients.Continue reading First Primary Care Develops DPC Integrated Health Plans
Minnesota, by simply removing the burden from the patient to the facility to establish eligibility under its financial assistance policy, is the market equivalent of Julius Caesar crossing the Rubicon.Continue reading Aldeen’s Sunday Morning Bathroom Read – Caesar Crossing The Rubicon Edition
Here’s more proof most decisions are made before board meetings begin. Vendor presentations are entertaining but seldom make a difference………….Continue reading Mission ISD Selects Insurance Consultant
Lt. Col. E. Rusteberg – West Point 1934 – Two Silver Stars, One Bronze Star, Presidential Unit Citation (Battle of Hatten), Purple Heart.
I knew little of my father’s participation in WW2 until after he died. Unlike veterans of today his generation didn’t talk much about it. Their quiet pride was enough, understood by all. The following recounts the Battle of Hatten in which my father was a participant. – Bill RustebergContinue reading Veterans Day 2023
Article Referred By Doug Aldeen
We’ll cut right to it:
We created a new healthcare company specifically for small businesses in Texas. We built it because small business owners want to provide health coverage so they can do right by their employees. And employees want to protect their families.Continue reading Special Legislation Brings New Health Plan Option For Texans
“Weight loss prescriptions Wegovy, Rybelsus and Saxenda — along with Ozempic — are driving health costs for employers up by more than $300 per insured worker this year .Continue reading Why Diet or Exercise When All You Have To Do Is Swallow A Pill?
“We now have 7 clinics in the RGV; 8 by the end of 2023; Weslaco, Pharr, McAllen (2), Harlingen, Brownsville, Raymondville and Edinburg by year-end. We employ 34 medical professionals with a plan to hire an additional 20+ by year-end. 18 months ago we had 1,500 members and today we have nearly 10,000 under contract.”Continue reading Frontier DPC Blitzkreig In Deep South Texas Liberates 10,000 Fee-For-Service Consumers From Managed Care Hell
Is The Grass Greener On The Other Side?
Most districts exiting the government health plan have failed while others have achieved unusual success. What makes the difference?
By Bill Rusteberg
It’s that time of year again when districts across the state are considering their health insurance options. Do they continue with TRS ActiveCare (TRSAC) or seek coverage on the commercial market? They have until December 31 to make their decision.Continue reading Thinking About Leaving TRS ActiveCare?
Starting as a 21 year old pharmaceutical sales rep. in Waco, Texas on a $17,000 a month “use it or lose it” expense account, this former drug pusher talks about his experience in the pharmaceutical industry, insurance companies and it’s effects on primary care physicians.Continue reading Fascinating Interview of A Former Texas Drug Pusher
“Prescription Drugs Are Too Damn High!
Change in prescription drug coverage leaves employees without medicineContinue reading TRS ActiveCare’s New Rx Program Under Fire
‘Attention Employers, Give Me Your Poor, Your Tired, Your Huddled Employee Masses………….” – The Great Aldeeni (Pictured above during his college years)
“Nonprofit hospitals are going to need help changing their behavior.”Continue reading Help Wanted: Assist Hospitals In Their Charitable Mission
Special Agent: Healthcare Services/Medical BackgroundContinue reading Biden FBI Job Opening – Houston Office
28-year-old makes over $210,000 a year working in a hospital—without going to med school………………..
This story is part of CNBC Make It’s Millennial Money series, which details how people around the world earn, spend and save their money.Continue reading Daughter of Immigrants Achieves The American Dream