Archive for the ‘Uncategorized’ Category

French Citizens: “Screw Covid Passports”

Saturday, August 28th, 2021

A single photo persuaded bureaucrats to drop face mask mandates during the 1918 Spanish Flu pandemic…………Will a 2021 French picnic picture bring back bureaucratic sanity?

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Schuessler’s Band Of Renegades Poised To Solve Health Care

Friday, August 27th, 2021

Carl Schuessler, Inventor of The Schuessler Stick™

Mitigate Partners with 30 independent offices across the United States act as the problem-solvers, consulting with businesses on employee benefits……………..

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Cash Pay Health Insurance Is The Future (and the future is now)

Friday, August 27th, 2021

Insured members pay for health care with cash provided by insurance plan funds and paid directly to medical caregivers at the point of service. No patient responsibility and no balance billing. Everyone wins, the plan, plan members and medical caregivers…………Meanwhile under traditional status quo health plans……………

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Insurance Payments Tied to Medicare Intrigue States, Employers

Friday, August 27th, 2021

Hospital Administrator Reacts To News

Montana’s state employee plan went from a projected $9 million deficit to $112 million in reserves by the end of 2017.

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BUCA Earns “F” In Health Care Cost Containment

Thursday, August 26th, 2021

A +4,000 life Texas school district self-funds their medical plan using a BUCA as plan administrator and PPO network provider. How has their plan performed in the last seven years?

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Long Live Primary Care

Sunday, August 22nd, 2021

“If we increase the spend on primary care so that primary care doctors can holistically manage their patient’s health, quarterbacking to specialists and coordinating care as needed, we can achieve lower overall spend on healthcare.”

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TRS ActiveCare Eager To Provide Claim Experience?

Friday, August 20th, 2021

After years of refusing to provide member districts their own claim experience, TRS officials now are eager to provide it. Why?

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Tyler, Texas Chamber Against Hospital Pricing Transparency Rules

Thursday, August 19th, 2021

Plaintiffs Chamber of Commerce of the United States of America (“U.S. Chamber”) and Tyler Area Chamber of Commerce (“Tyler Chamber”) (collectively, “Plaintiffs”), bring this action for declaratory and injunctive relief against the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, the Department of Labor, the Employee Benefits Security Administration, the Department of the Treasury, the Internal Revenue Service, and the current heads of those agencies in their official capacities (collectively, “Defendants”), alleging as follows:

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Man Sentenced To Death For Refusing Vaccination

Thursday, August 19th, 2021

Transplant patient taken off list for refusing to take the Chinese Flu vaccination……

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Dallas ISD Offers $500 Vaccination Incentive

Wednesday, August 18th, 2021

Coach Joe Sixpack and his pals are planning to get vaccinated at least ten times just to be sure. “We’re gonna use the money to help pay for our TRS ActiveCare we can’t afford to use” said Coach Sixpack.

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Commission Relationships in Health Care

Wednesday, August 18th, 2021

 

The Healthcare Industry is Filled with Commission Relationships Where Money Is Paid, But It Is Not Always Obvious.

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Decision Time: TRS ActiveCare or Commercial Health Plan?

Sunday, August 15th, 2021

Senate Bill 1444 brings districts to a fork in the road. One takes them out of the health insurance business and the other puts them smack dab into it…..

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The Duopoly That Controls Your Pharmacy Benefit

Friday, August 13th, 2021

Dear Plan Sponsor, do you think you control your Rx plan? Think again…………..

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Dead People Paid By Government Health Plan

Thursday, August 12th, 2021

Dead people have been known to vote, now we learn they get health care while dead too…..Next thing you know we’ll elect dead people to Congress………….

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Why a $60 Hospital Bill From 1955 Went Viral

Thursday, August 12th, 2021

Babies cost $59.95 back in the 1950’s. I was almost free in the decade before that. Babies are worth a lot more these days………….

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You’ve Got The Body Now You Want My Soul

Thursday, August 12th, 2021

You’ve got the body now you want my soul………….Ill do almost anything you want me to do but I cant do that, no, no, no………………Ain’t accepting any balance billing baby!

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Court Finds Charter School Benefit Plans Fall Under ERISA’s Governmental Plan Exempt

Thursday, August 12th, 2021

“Because the state not only funds the charter schools but also approves their establishment and continued existence, it is not appropriate to treat them as private institutions subject to public regulation.”

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TRS ActiveCare or Commercial Health Plan?

Wednesday, August 11th, 2021
“When you come to a fork in the road, take it” – Yogi Berra

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The Kind Of Prospect We Want To Do Business With

Wednesday, August 11th, 2021

Yesterday’s meeting with a prospect was memorable. The group’s in-house risk manager listened politely, then towards the end of the meeting got up and started drawing a diagram on the board, while narrating at the same time.

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Monday, August 9th, 2021

Welcome to Global Health Management, Canada or as we refer to ourselves: GHM Canada.

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Public Consulting Group

Sunday, August 8th, 2021

We believe in the power of the public sector…………………….

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Where is the medical cost trend headed in 2022?

Sunday, August 8th, 2021

Healthcare spending is expected to return to pre-pandemic baselines with some adjustments to account for the pandemic’s persistent effects.

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TRS ActiveCare Flips: Will Release Claim Experience

Sunday, August 8th, 2021

Can an employer access claims data to compare TRS-ActiveCare to other options for employee health benefits?

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Easy Issue Life Insurance With Return of Premium Benefit

Saturday, August 7th, 2021

If They Want to See A COVID “Passport” – Show them This!

Saturday, August 7th, 2021

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How Banning Surprise Billing Changes MultiPlan’s Business

Friday, August 6th, 2021

Political winds threaten the stability of MultiPlan’s core business……..

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Question for Health Insurance Experts

Friday, August 6th, 2021

Plans have been known to exclude coverage for “risky” behavior………

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The Robin Hood Risk Adjustment Program

Wednesday, August 4th, 2021

To protect against potential effects of adverse selection and help stabilize premiums in the individual and small group markets, the (Robin Hood) risk adjustment program transfers  funds from plans with relatively low-risk enrollees to plans with relatively high-risk enrollees.

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What European Country Is This?

Tuesday, August 3rd, 2021

National Ambulance Service reach all over the country within 15 minutes…………

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Government Considers Onerous Punishment For Renegade Hospitals

Monday, August 2nd, 2021

Government bureaucrats consider upping punishment for non-compliant hospitals…….

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Consumers Blame Insurers Surprise Medical Bills

Monday, August 2nd, 2021

Blame Game In Health Care

Whatever happened to individual responsibility?

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Hospital Price Transparency – Not a Cure for the Disease

Sunday, August 1st, 2021

Transparency has revealed just how absurd the current contracting process is, and has in many ways caused more confusion and obfuscation……………….Costs could very likely rise in many markets as systems learn about higher prices being charged by their competitors – the definition of ‘unintended consequence………….

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The Most Outrageous Salesman I Ever Filmed

Friday, July 30th, 2021

By David Hoffman

This is a clip from my first documentary feature film called King Murray. It won the Cannes Film Festival Critics Prize in 1970. Murray King was a most amazing character and ended up selling me life insurance….. at 27 years old!

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Aflac Faces a Tight Labor Market

Friday, July 30th, 2021

AFLAC facing distribution pressures due to the Chinese Flu………..

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Former Healthcare Executive Insider Seeks Redemption

Friday, July 30th, 2021

The author’s message is clear. And it’s real. But there is something else within the article that’s a condemnation of our current health care system of finance in this country – If You Can’t Pay Your Gonna die.

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Cheech & Chong Insurance?

Friday, July 30th, 2021

Insurance Agents Cheech & Chong Out Making Cold Calls

Cheech & Chong, in their best dreams of years gone by, would have never thought possible mainstream insurance brokerage would ever promote a canabis benefits captive. Their idea of “captive” was that it was really bad and something to avoid.

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Government Bureaucrats To Cut 258 ASC Procedures?

Wednesday, July 28th, 2021

With the magical stroke of a bureaucratic pen a list of the procedure codes may be removed from the ASC payable list, including several heart and spine procedures…………….

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Happy Birthday!

Wednesday, July 28th, 2021

Legislation Introduced to Fix Health Insurance ‘Birthday Rule’

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Scott v. UnitedHealth Group, Inc (Cross-Plan Offsetting)

Wednesday, July 28th, 2021

“When United and a provider dispute whether a claim was overpaid, cross-plan offsetting allows United to act as judge, jury, and executioner.”

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Ruben Edelstein

Tuesday, July 27th, 2021

By Bill Rusteberg

Ruben Edelstein practiced managed care in his own way. The son of immigrants, he ran a successful furniture business in South Texas. An astute businessman, he grew the business with locations throughout the Lower Rio Grande Valley in deep South Texas.

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Willis Earns $1 Billion Termination Fee

Monday, July 26th, 2021

AON Representative Reacts To The News

Aon will pay the $1 billion termination fee to Willis Towers Watson…………..

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Dr. Hodad, M.D.

Friday, July 23rd, 2021

“Somewhere in the world, there is the world’s worst doctor, and someone has an appointment with them tomorrow” – George Carlin

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TRS ActiveCare Under Massive Attack

Thursday, July 22nd, 2021

Will TRS ActiveCare survive massive assaults by hordes of commercial invaders who believe victory is a given? Battle plans incorporate common sense, reason and logic geared to winning in time for the TRS ActiveCare Armistice Day deadline set for December 2021…..

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Not All Patients Are Treated Equally……Or Are They?

Wednesday, July 21st, 2021

a close up of text on a white background

Unfortunately health plans traditionally do not discriminate by choice of in-network provider because members pay the same no matter who they visit for health care.

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Swiss Re Group & Medical Summit

Tuesday, July 20th, 2021

We are thrilled to invite you to our Group & Medical Client Summit on September 13 – 14, 2021.

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USBenefits Insurance Services, LLC

Tuesday, July 20th, 2021

USBenefits Insurance Services, LLC is a full service Managing General Underwriter, providing Medical Stop-Loss Reinsurance for employer groups through qualified Third Party Administrators and select brokers.

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Phone Call Recordings May Be Requested by Claimants

Monday, July 19th, 2021

Phone Call Recordings may be Requested by Claimants if They’re Deemed Relevant to a Benefits Claim

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Private Equity Is Ruining American Healthcare

Monday, July 19th, 2021

The rise of PE in medicine has resulted in a proxy war against insurance companies exclusively for the benefit of clandestine shareholders and investment fund managers rather than patients or clinicians………………..

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Sunday, July 18th, 2021

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Attention Stop Loss Carriers

Friday, July 16th, 2021

John Powers Rocks On…………..

Friday, July 16th, 2021

Powers is an expert on reference-based pricing (RBP), having worked on RBP plans for over a decade……………..

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The Taste of Success In A World of Failure Is Addictive

Friday, July 16th, 2021

Those that don’t play by the rules get the same benefits they have always had but wish they didn’t because they want something better and cheaper………….

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2021 Milliman Study

Friday, July 16th, 2021

HOLY COW!

Interesting Milliman study on health care costs. A lot has changed since 1973………..

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The Power of “Skin In The Game”

Thursday, July 15th, 2021

If this patient didn’t have “Skin In The Game” he would not have shopped for care.

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Camp Coverage In A Five Minute Phone Call

Wednesday, July 14th, 2021

Camp Coverage in a 5 minute phone call – 1-800-334-5579

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DPC + CPO = Better Benefits, Lower Costs

Wednesday, July 14th, 2021

As insurance costs continue to soar you will see a rapid growth in strategies like this among the ever shrinking community of independent PCP’s who remain adverse to the shackles of managed care contracts and hospital ownership of their practice………

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How Montana Is Revolutionizing Healthcare—With Markets

Tuesday, July 13th, 2021

Increasingly fed up with red tape, paperwork and meddlesome third-party rules—especially since passage of Obamacare—a growing number of physicians are opting to bypass both government and insurance companies.

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D.W. Van Dyke Announces Completion and Distribution of its Medical Stop Loss Industry Target Loss Ratio Survey 

Tuesday, July 13th, 2021

Survey results for the January 2020 business indicate a continuation in the favorable loss ratio trend with more than half of all participants achieving or exceeding their respective target loss ratios.

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Texas Eliminates Life & Health Counselors License

Monday, July 12th, 2021

Fee based insurance consultants in Texas have been required to hold a Life & Health Counselors License issued by the Texas Department of Insurance. Now anyone who claims to be a fee based consultant and holds a General Lines insurance license may provide insurance consulting services.

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Insurance Consultants Make Pitch To ECISD

Monday, July 12th, 2021

The Edinburg Independent School District held public job interviews for insurance consultant and five showed up to make their pitch.

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Cool Hand Luke Starring Tommy Taylor

Sunday, July 11th, 2021

ATTENTION INSURANCE CONSULTANTS: If you have two hours of free time and want to watch one of the best insurance consultants in our industry deal with a passive aggressive school board this is it.

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Where Did Our $19,000,000 Go?

Sunday, July 11th, 2021

“Who, me? I don’t have it!”

Edinburg ISD’s self-funded health plan lost $19,000,000 in 18 months and they want to know where it went.

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Requesting Fee Increase With Insurance Companies

Saturday, July 10th, 2021

It’s on us as practitioners who take insurance to be assertive and request fair reimbursement rates……………….

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Aflac: How To Become An Insurance Agent In Texas

Friday, July 9th, 2021

By Bill Rusteberg

In March 22, 1982 I quit my job with a major insurance company to strike out on my own as an independent  commissioned insurance agent. By late July I was nearly broke and worried.

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Ada Betty Finley

Friday, July 9th, 2021

The day after college graduation, Ada Betty took the exam to obtain her Recording Agent’s Insurance License. She passed the exam and became the youngest licensed recording agent in the state of Texas, at the age of 20. Her father, J.C. Dunn, founded the American International Life Insurance Company in Harlingen in 1952 and Ada Betty served as Vice President upon obtaining her license.

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Gun Insurance Mandate

Thursday, July 8th, 2021

California city requires all gun owners to maintain gun insurance……..Meanwhile back at the ranch, Texas enacts Constitutional Carry effective September 2020……….

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Pyongyang General Hospital Demonstrates “Love For The People”

Wednesday, July 7th, 2021

Kim was furious when he received reports  that officials tried to import Chinese, not European, medical equipment. Those involved in the import of this equipment were reportedly executed……….

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Vori Health

Wednesday, July 7th, 2021

Vori Health Raises Additional Capital from Strategic Partners Intermountain Healthcare, Ascension Ventures, and Echo Health Ventures

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Pssst….Want To Make $3.2 Million Next Year?

Wednesday, July 7th, 2021

Godfather, The Cat’s Out of The Bag!

An aggressive insurance agent with relationships with school districts can make a lot of money by taking advantage of the Small Group definition by forming a cooperative for school districts as an alternative to TRS ActiveCare.

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Insurance Brokerages Targeted For Extortion

Tuesday, July 6th, 2021
Ransom monies are probably going to Russia to pay for Ferraris in Moscow…………………….

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Texas Insurance Company In Receivership

Monday, July 5th, 2021

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Health Insurance Is Not Really Insurance Anymore

Monday, July 5th, 2021

By Molly Mulebriar

Health insurance in the United States is no longer insurance in the traditional sense. It’s become an entitlement welfare scheme that’s fast becoming a heavily regulated government utility.

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Why Insure Expected Risk?

Monday, July 5th, 2021

If we don’t buy FAN BELT insurance then why do we buy insurance for routine doctor office visits? A routine office visit costs around $75 – $150 depending on who you see and the type of visit. Insuring a $75 benefit doesn’t make sense and ends up costing more.

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How To Give Employees A Raise Without Giving One

Saturday, July 3rd, 2021

The erosion of the American middle class continues due directly to the medical-industrial complex. It’s time to stop that by giving working Americans better health care that costs less…….

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Underwriting Risk Is Based On Data

Saturday, July 3rd, 2021

“He who has data wins. He who has good data wins a lot. He who has real time data wins all the time” – Bill Rusteberg

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