August 2024 – Risk Managers

Attention Providers – Design A Custom Community Health Insurance Product In Under 90 Days

Diversify healthcare provider’s revenue and create more value for local employers.

Employee Attains Room Temperature While Working

Little did her co-workers know that Denise had assumed room temperature in the comfort of her office cubicle four days earlier.

‘If I Have A Heart Attack Tomorrow, Why Should I Stay Dead?

A British woman who developed hypothermia while hiking in Spain in 2019, whose heart stopped for six hours while rescue teams tried to locate her was revived…..

Curative Expands Groundbreaking Health Plan to Georgia with an Innovative $0 Copay, $0 Deductible* Benefits Solution

AUSTIN, Texas–(BUSINESS WIRE)–Aug 29, 2024–

Curative Insurance Company, a pioneering healthcare services company, is excited to announce the expansion of its first-of-its-kind health plan to businesses headquartered in Georgia. This marks a significant milestone as Curative brings its $0 copay, $0 deductible solution to Georgia.* The plan is designed to remove barriers to care, prioritizing member well-being, preventative care, and long-term health while reducing overall costs. Georgia is now the third state, along with Texas and Florida, where Curative is available to employers with 51 or more employees for their entire workforce regardless of the employee’s state of residence.

Reference Based Pricing Benchmarks – Why Pay More When You Can Pay Less?

What’s the best Medicare pricing benchmark plan sponsors should use? Is it 100%, 120%, 150% or 200% of Medicare? Is there a material difference in balance billing issues between these tiers? The answer may surprise you.

Helping Hospitals Solve the Balance Billing Issue With Reference Based Pricing Plans

ATTENTION HOSPITALS: Rejoice and be Happy! The Reference Based Pricing battle has been won! You have been so successful in putting the Fear of God among local plan sponsors considering Reference Based Pricing that it’s had the intended effect.

Allstate Exits Voluntary Benefits Business

“Allstate Corp. has agreed to sell its employer voluntary benefits business to StanCorp Financial Group Inc. for $2 billion, with plans also underway to divest its individual and group health sectors. This move is part of a broader strategy to focus more intensely on its core personal liability and protection services.”

94% Reject Reference Base Pricing

It’s been seventeen years since we placed our first client on a Reference Based Pricing model. The results were compelling with first year savings exceeding 44%. Subsequent years proved equally successful with continued savings and no reduction in benefits.

Greg Lindberg

Greg Lindberg bought over 100 insurance companies and loaned out carrier reserves to the tune of billions of dollars winning a seven year all-expense paid sabbatical at taxpayer expense.

BestOne Dental Coverage Now Available

BestOne Dental – $25 per visit co pay

Affordable Dental Coverage – 12 Month Rate Guarantee!

Choice Plan ($3,000 or $5,000)
Economy Plan ($1,500)

The Doctor Will See You Now

Have you ever…

Needed a doctor in the evenings or on the weekends?
Needed a prescription called in to your pharmacy?
Needed to talk to a doctor about a non-emergency illness?

MDhotline is a nationwide network of medical physicians who provide medical advice and issue non-narcotic prescriptions (when sufficient medical history is available) to expedite hassle-free treatment. MDhotline staffed with licensed, registered nurses to speak to members regarding their medical needs and to arrange consultations with MDhotline Doctors 365 days a year / 24 hours per day / 7 days per week.

Enrichly – “Prepare to Crush Your Competition”

The market is changing, awareness and adoption of alternative program designs are growing, but many brokers and employers have yet to implement programs that really deliver meaningful impacts to the end consumers, the employees because they lack the tools to effectively manage them across large populations.

Enrichly delivers a turnkey platform that makes it easy for you and your firm to win in the quickly evolving health and benefits game — from marketing and lead generation to sales and support. Our Network Partner Program allows you to launch fast and kick your competition to the curb., if that doesn’t interest you this is not the program for you or your firm.

Group vs Individual Health Insurance

THE GREAT DEBATE: Group Health Broker vs Individual Health Broker

“Because the ACA requires minimum levels of coverage and prohibits insurance companies from denying people coverage because of pre-existing conditions, individual plans are better and easier to get. Plus, they’re often more affordable than comparable group plans.” – On Exchange vs Off Exchange – Individual vs Group Health Plans .

Why do Health Plans Need a Comprehensive Solution to Offer ICHRA Plans?

August 8, 2024

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The small group market is the backbone of every health plan. Yet, this market is undergoing unprecedented levels of disruption.

ICHRAs, Disintermediation, and the Opportunity for Brokers

“Some brokers will do everything that they can to deflect client requests to evaluate an ICHRA program to replace their group model. That approach is fraught with danger, particularly when unlicensed sellers can deliver a solution.” – Bill Stuart

The $362.50 Defined Contribution Health Plan

The “Tack Hammer Penalty”

ATTENTION LARGE EMPLOYERS: Here’s How The Government Makes It Possible To Limit Your Health Plan Cost To $362.50 PEPM starting in 2025:

Uncle Sam Insurance

Meet Uncle Sam, your new health insurance broker. With his assistance you can shop for health insurance all by yourself in a few short New York minutes. And the good news is your new best friend may help pay part or all of the cost if you qualify.

Even better news for American workers! Uncle Sam says your employer can help pay all or part of the cost too if they adopt ICHRA, the newest employer sponsored health plan that’s gaining rapid market share across the Fruited Plains, from East to West, from North to South.

RFK Explains Why Americans Are The Sickest People On Earth

An honest discussion by RFK on American health care every plan sponsor should share with their plan members.

The Stop Loss Waiting Game

In a hurry for a stop loss quote? Get ready. The stop loss waiting game can take weeks and weeks of grueling back and forth effort often leading to dreams of an early retirement to a warm and sunny beach with plenty of umbrella drinks on hand……

Fidiciary Liability Insurance

Did you know “In Texas, there is no formal fiduciary duty between an insurance agent and an insured.

Medical Conditions That Dogs Can Sniff Out

Dogs possess an extraordinary ability to detect certain medical conditions through their keen sense of smell. From detecting cancer to identifying low blood sugar levels, these remarkable animals offer invaluable support by alerting humans to potential health issues early.

Plumb Life Insurance Company

How to become a Plum Partner and start earning BIG BUCKS…..

Uncle Sam Health Insurance

Meet Uncle Sam, Your New Best Friend & Health Insurance Broker

Buying health insurance has never been easier. Meet Uncle Sam, your new health insurance broker. With his assistance you can shop for health insurance all by yourself in a few short New York minutes. And the good news is your new best friend may help pay part or all of the cost if you qualify.

Still better news is……(DRUM ROLL)…………. Uncle Sam says your employer can help pay all or part of the cost too if they adopt ICHRA, the newest employer sponsored health plan that’s gaining rapid market share across the Fruited Plains, from East to West, from North to South.

Open Enrollment

Billy Eats Your Medical Bills

BILLY helps take a bite out of opaque healthcare pricing, making it easy to compare prices across facilities before scheduling care, or to review what a usual and customary charge really should be on your bill.

Alamo Heights ISD Accepts Low Bid

“It all comes down to cost……….”

Auto Insurance: Overpriced

Just because you have to renew your auto insurance every 6 months does not mean you have to Over Pay!

Charlie Munger Opines On Insurance

This Blog Entry Stolen From Taylor Rogers’ Linkedin Post – Charlie Munger would teach you to buy as little insurance as you can afford to.

Risky Risk Pools Plague Texas School Districts

“How can a superintendent or school board, as fiduciaries of taxpayer funds, jeopardize a district’s assets by participating in a risk pool, when they have no idea as to the pool’s financial ability to pay losses?” – Robert Reim

Replacing Your District Health Insurance Contribution with Federal Dollars

With increases to public school funding seemingly frozen by the state’s leadership as the result of a fight between the legislature and the Governor over vouchers, public school districts are being forced to find creative ways to balance their budgets, including discovering new and innovative cost cutting measures.

What The Heck!

ICHRA Sales

Not all ICHRA administrators treat insurance agents the same. Many administrators “own” the account and can terminate the agent at will. And they keep all commissions as Agent of Record and pay the broker nickels and dimes and other strange things. Others, like the one described below, treat agents better.

How To Calculate ICHRA Affordability

The cost of health insurance for an employee must not exceed 9.12 percent of the employee’s income.

Market Saturation Plagues Barnum & Bailey Talent Pool

Two thirds of the American population could have made it big in the circus had they lived back in the day. Now the other third can.

E&O For Insurance Agents

E&O Insurance and Benefits for Agents, Agencies, RIAs and Financial Planners. Apply online in minutes and receive instant proof of insurance.

TRS ActiveCare Or ICHRA?

Can the TRS ActiveCare (TRSAC) government health insurance program for Texas school districts effectively compete with ICHRA? Which is better? It’s up to the reader to decide.

TSHBP Member Districts Hit With $18,519,802.78 Funding Deficit

The bankrupt TSHBP is attempting to collect millions from member Texas school districts to pay for uninsured losses for plan year 2024-2024.

Risk Pooling: How Health Insurance in the Individual Market Works

ICHRA’s – The Power of Risk Pooling

“The Affordable Care Act (ACA) requires that insurers use a single risk pool when developing premiums. The single risk pool incudes all ACA-compliant plans inside and outside of the marketplace/exchange within a state. In other words, insurers must pool all of their individual market enrollees together when setting the prices for their products. This means that the costs of the unhealthy enrollees are spread across all enrollees.” – American Academy of Actuaries

ICHRA 2025 Rate Filings

EMPLOYEE OWNED HEALTH INSURANCE unleashes the power of free market choice: “I’ll take the plan with the rate reduction!”

The Rise of Employee Owned Health Insurance

The decades old phenomenon of Employer Owned Health Insurance is fading away proving nothing is permanent. We now see the rapid rise of Employee Owned Health Insurance.

The Insurance Industry is Passing the Torch to ICHRA

“Since 2020, I have been 100% focused in the ICHRA industry. The ICHRA Shop is NOT an ICHRA administrator but a broker’s broker, a GA for ICHRA, and consultants to large employers.”

Providers Win Almost All The Time Under The No Surprises Act

With providers winning 82% of settled cases in Q3 and Q4 2023, according to the CMS report, the incentive to continue filing a high volume of disputes is apparent.

Doctors Turn To Farming To Survive

“It’s hard to say whether I’m a doctor or a farmer …..”

How To Enroll On The Compassionate Care Plan

The Compassionate Care Plan™ is a risk management strategy for self-funded employer groups providing an effective method of transferring high risk plan members to the individual health insurance market.

Best Managed Care Discount In The Market

I had occasion to try out my government health plan a few weeks ago at our local community hospital emergency room. I knew ER visits could be expensive and wondered what the bill would be.

How Employer Health Insurance Could End After The Election

Average Healthcare Costs 2024

Average health insurance cost for single coverage is $600 per month. Segal Consulting stated much the same for TRS ActiveCare in their 2023 report.

ICHRA Sales Explode

No-Prescription Online Semaglutide Poses Multiple Risks

SOURCE: Medscape

Semaglutide products sold online without a prescription may pose multiple risks to consumers, new research found.

Ozempic Drugmaker Goes After Compounded Drug Products

“We will continue to evaluate any and all appropriate actions against entities that violate Novo Nordisk’s intellectual property rights in connection with their sale of compounded drug products purporting to contain semaglutide,” – Novo Nordisk

The Texas Heart Institute Implants BiVACOR® Total Artificial Heart

First-in-human novel valveless artificial heart implanted in a patient with end-stage heart failure as a bridge to heart transplant

ICHRA Rates To Rise 9% or More In 2025

ICHRA plans will see rates rise by 9% or more. Who will pay the increase, plan sponsor or plan member?

Hospital Quotes Fuck You Cash Price

By Chris Barakat on Linkedin

This afternoon, Geetinder Goyal was advocating for one of his patients. The facility is a huge branded facility in Houston.

Pseudocide Earns Man 15 Months of Rent Free Government Housing Plus Free Food

In 2000, Australian millionaire Harry Gordon tried to get a AU$3.5 million payout from his life insurance policy by faking his own death.

ICHRA: For Employers Who Are Not Going To Take It Anymore

ICHRA:

For companies tired of never ending rate increases and all the time and effort required to provide health insurance for valued employees.

RBP Plans To Receive +2.7% – 3.3% Cost Increase For 2025

Government price controls set to increase costs for Reference Based Pricing plans in 2025

Reference Based Pricing plans benchmarking claims against Medicare reimbursement rates will be paying more next year for all inpatient hospital care. For profit hospital in-patient care RBP reimbursement will increase by 3.3% while non-profit hospitals in-patient care will increase 2.7%.

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