SAN BENITO — Superintendent Antonio Limon said Wednesday that he is conducting an internal investigation that focuses on an exchange of emails about the district’s insurance carrier.

Limon declined to disclose the names of the persons who exchanged the emails.

On May 16, a district memo stated that school board President Yliana Rodriguez announced that Robert Champion Jr. and the Salazar Insurance Group would handle the school district’s $8 million health insurance business.

Two days later, Rodriguez rescinded the action before the Texas Education Agency told the district that she failed to obtain the school board’s approval to hire the insurance carriers.

Limon fired longtime risk manager Janie Gonzalez on Aug. 24, but declined to say why.

Board member Oscar Medrano said Gonzalez told him that Rodriguez told her to write the memo.

Gonzalez has declined to comment, and Rodriguez has refused to say whether she told Gonzalez to write the memo.

Limon said he discovered the e-mail exchange as a result of a public records request for the messages, but he would not say if these e-mails are the same as those requested by the Valley Morning Star.

The Star on Aug. 24 submitted an open records request for e-mails between Gonzalez and Rodriguez; district insurance consultant Glenn Hillyer; district purchasing agent Adrian Garcia; Robert Champion Jr.; Robert Champion Sr.; and the Salazar Insurance Group and Joe Salazar.

School attorney Scott McDonald, an attorney with the Austin law firm of Kevin O’Hanlon, refused on Wednesday to release the e-mails that Limon had readily available, but said the e-mails would be released today.

http://sbnewspaper.com/?p=7952

fernandodv@valleystar.com

Some hospital networks are cutting out the middle man and becoming insurers, themselves, Kaiser Health News reported. As a growing response to flat-rate payments for care rather than the traditional fee for service, hospital chains are making the move to change their business model.
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Insurance agents compete for business with other agents. Insurance companies usually honor proposal requests on a first come, first served basis. Below is a redacted email we received yesterday which we believe may illustrate how an agent will and can  ”lock up” the market before his competitors can do so. Note the times of the emails:

From: Insurance Agent Jones
Sent: Monday, August 20, 2012 03:32 PM
To: ‘aetna’ <largegrouprfp@aetna.com>; ‘BCBS’ <bcbssanantoniorfp@bcbstx.com>; ‘BMA’ <gsaenz@bmatpa.com>; ‘Boon Chapman’ <info@boonchapman.com>; ‘Caprock Health’ <dkoch@caprockhp.com>; ‘EBS’ <olivia@ebsincorporated.com>; ‘GPA’ <mattm@gpatpa.com>; ‘Great West’ <catherine.bishop@gwl.com>; ‘Healthsmart’ <jennifer.smith@healthsmart.com>; ‘Humana’ <jgasper@humana.com>; Jennifer L Henry; ‘Providence Admin’ <kferguson@pristx.com>; ‘trustmark’ <james.murphy@trustmarklife.com>; ‘UMR’ <aaron_r_daniels@uhc.com>
Subject: FW: Inurance Proposals Packet

Please let me know if you will offer a proposal on this group.

Thanks

Insurance Agent Jones

From: HR Director of ABC Company
Sent: Thursday, August 16, 2012 2:38 PM
To: Insurance Agent Jones
Subject: Inurance Proposals Packet

Mr. Jones,

I have attached the following information for the Insurance Proposal for our facility. Please contact me if there is anything else needed.

Thanks,

Happy HR Director of ABC Company

Editor’s Note: Agents who successfully lock up the market in a competitive bid situation effectively controls the bid process. Prior to submitting his bids, the agent knows the contents of each bid and can play favorites if so inclined. “Hey buddy, your competitor, XYZ Insurance Company is 5% lower than your quote, you need to drop your rates 10% and add another $20,000 in commissions.”

From an insurance broker:

What is telling about this are the email addresses used. I can tell you some are addressed to people who no longer work for the carrier contacted. One in particular left over a year ago. The other email addresses are general box email addresses anyone can get off the internet. This agent is shotgunning the market to lock it up.

From Harvey the Rabbit:

It’s not 54 minutes. It’s more like 4 days and 54 minutes. But I get the point.

As health care costs continue to increase, employers are looking for ways to cut costs, such as reducing spouse and dependent coverage in 2013, says a study out today.

The Health & Group Benefits Consultant is an integral part of the overall client management and client relationship function in the Southern Employee Benefits region. Focus will be on developing and growing the Health & Group Benefits practice by effectively building, growing and maintaining client relationships.

(more…)

http://ccrta.org/rta-business/

http://sbnewspaper.com/?p=7900

“Medicaid is about as far from a normal business as one can imagine. It is the emergency room for our worst chronic social problems. Illiteracy, drug addiction, broken families, migrant labor, illegal immigration, teen pregnancy – you name it, and Medicaid gets to deal with it.”

(more…)

Is the San Benito Independent School District really seeking direct contracts with medical providers or simply accessing an existing PPO rental network on a private label basis? For clues, watch the last 15 minutes of this insurance workshop video:

http://www.youtube.com/watch?v=TPN9aHZ1PuI&feature=youtube_gdata_player

We have recieved quite a few emails on the posting immediately preceding this one, from all parts of the country. San Benito ISD has sparked a lot of interest in the brokerage/consulting community – a fascinating case study.

Prior Postings on San Benito ISD: http://blog.riskmanagers.us/?p=8986, http://blog.riskmanagers.us/?p=9019, http://blog.riskmanagers.us/?p=9046, http://blog.riskmanagers.us/?p=9064

From an actuary firm:

Bill, I watched the entire video. My God! Did you get the part about the TPA not charging anything until they get a claim? They are working off a percentage of savings! Who is their actuary?

From a reinsurance broker:

The first 58 minutes is more entertaining than the last 15 minutes. Consultant lacks polish. Board lacks brains.  We wouldnt put up with either up here.

http://www.youtube.com/watch?v=TPN9aHZ1PuI&feature=youtube_gdata_player

Editor’s Note: Also see http://www.youtube.com/watch?v=6RiES1JQFZA&feature=youtube_gdata_player