Category: Uncategorized

“I come from an environment where if you see a snake, you kill it. At GM, if you see a snake, the first thing you do is hire a snake consultant. Then you get a committee on snakes and discuss it for a couple of years.” – Ross Perot

Cold calling was scary as hell when I first started as a 22 year old selling cleaner, more efficient homes. After a day’s training, I was taken to a residential street in a nearby city and told “Ok Bill, get out and start knocking on doors.”

FDA allows Florida to import prescription drugs in bulk from Canada.

By Berkeley Lovelace Jr.

The new policy will allow Florida to buy prescription drugs in bulk. The drugs will be made available through state-run programs such as Medicaid.

HR. DEPARTMENT: Our TPA is Gilsbar……………… I, I, I mean HealthComp. Opps I meant to say Virgin Plus!………Forgive me, I think I’m losing my mind, I’m so confused!

CEO: But didn’t Hank Say……………………

Family To Sue Over ‘Wrongful Death’ of Eddie Bernice Johnson

Late former Texas congresswoman Eddie Bernice Johnson’s family intends to sue Baylor Scott & White for alleged “medical negligence” that led to her death.

Pharmacies across the country are dealing with a flood of requests for medical and alternative sleep medications…..In the last three months, close to a hundred thousand distress calls were registered about a feeling of loneliness, depression, anxiety, suicidal thoughts…………

“Our plan pays claims using Medicare as a benchmark plus a 50% bonus. In this instance that totals $1,350 for Joe Sixpak’s one hour emergency room visit” says the emaciated plan sponsor.

Legacy TPA’s are slow to adapt to market changes and even slower investing in the latest technology whereas new, “upstart” TPA’s invest in the latest technology giving them a distinct advantage.

Eli Lilly launches website to get obesity drugs shipped directly to patients via telehealth

Drugmakers to Hike Prices on 500 Drugs 

Big pharma companies including Pfizer are planning to raise prices on more than 500 drugs this month, according to a recent Reuters report.

Group captive programs are a specialized form of health insurance that allows multiple employers to come together and collectively fund and manage their employee health benefits. It’s a win-win: companies gain more control over their health insurance costs and potentially save money by sharing the risks and rewards of their healthcare program.

Watch how Kingfisher, a sales representative for George Stevens Insurance Company, underwrites and sells a Flight Insurance policy in real time………….

Finding solutions to lower health care costs has never been easier for citizens of Pecos County, Texas. Most qualify for free hospital care provided by the only hospital in the county.

Sunday Morning Bathroom  Read (1st Gag Clause Violation of 2024 Edition)

For the Second Time, Capital Rx Makes the Inc. 5000, With Three-Year Revenue Growth of 903% Percent

“The company quietly loaned $600,000 to James on the condition that his political connections would bring the company funding from the Middle East.”

“Biden told me there’s not a single door in the country that we can’t open. So if I wanted to meet, you know, the head of Google, it’s a phone call” – Grant White, CEO

SOURCE: FDA warns consumers not to use counterfeit Ozempic (semaglutide) found in U.S. drug supply chain | FDA

[12/21/2023] FDA continues to investigate counterfeit Ozempic (semaglutide) injection 1 milligram (mg) in the legitimate U.S. drug supply chain and has seized thousands of units of the product.

Johnny talks about his visit to Dr. Kirby, an Eye, Ear, Wallet doctor……….

For less than $10 pepm (as low as $6) a national law firm offers Reference Based Pricing plans protection services against balance billing and full legal representation in case of a lawsuit.

2024 Individual Health Insurance Enrollment Sets Record.

A record 19 million Americans are expected to purchase individual coverage with other people’s money for 2024 effective dates.

The move demonstrates continued strategic growth and strengthens its position as a leading consolidator in the industry

These rates will save Killeen Independent School District $10,000,000 in 2024

“The proposed rates for Killeen ISD are higher than the region’s rates but are still going to save Killeen ISD about $10 million off of the projected spend if they had stayed with their current provider.“

“Clear Point defies the constraints of the current market by offering an attachment point equal to the expected claim amount.”

“Now I have almost $2,500 more to go! I could have come closer to meeting my deductible, earning 100% coverage for the rest of the year, but NO, you had to introduce me to Chris Barakat!!” screamed the patient.

By WILLIAM H BESTERMANN JR MD

Costa Rica is a country in Central America between Nicaragua and Panama. Central America is a harsh place, right? Refugees seeking asylum from Central America have created a border crisis in our own country with thousands fleeing horrible conditions and coming into the United States daily. Here is a shocking fact. Citizens of Costa Rica live longer than we do! Can that possibly be true?

“Medical practice that rely to heavily on insurance based payments will at some point find themselves underwater.”

” Children can be a little rough so it gets tugged and pulled a lot, and then there is the soot and the danger of being singed when I head down the chimneys” – SANTA CLAUS

Cancer stricken undocumented woman receives life saving medical care through an unregulated, no deductible, no network medical sharing program.

Harbor Health expands to serve the entire Austin metro area. See us for primary and specialty care.

“A podiatrist in New York City elected to use an assistant surgeon for a bunionectomy and two hammertoe procedures, both common surgeries. That assistant alone billed $169,410. Fair compensation as determined by our classification, edits, and review process was $632, or 0.37% of the assistant’s bill.”

From the critically acclaimed and historically accurate 2004 film recounting Hitler’s last days comes the perfect dramatic platform to rant about U.S. Health Insurance Industry.

Our greatest national asset is our children. Why aren’t we taking better care of them?

About time! From our experience in managing health care costs, CVS is one of the highest priced drug retailers on the planet. Most of our groups have eliminated CVS from their pharmacy network.

Ever thought about investing in a TPA? If so now may be a time to invest in Marapai.

More plan sponsors are adopting Cash Pay Centric Health Plans while others are Tip-Toeing-Through-The-Tulips with Cash Pay Bolt-On Models……………The coming demise of PPOs networks?

Most Hospitals in America Use the Cost-to-Charge Ratio to Estimate Their Costs for Specific Services Such as an MRI, Surgery or Endoscopy. However, the Cost-to-Charge Ratio is Inaccurate.

Seating arrangements affect behavior, presetting the stage for human interaction, subconsciously intending to produce desired outcomes.

Methodist (Houston) quoted a Cigna insured patient today a price of $1,053.36 for CPT 76982. All of that goes to the patient’s Cigna deductible.

Ozempic and other similar weight reducing drugs are expensive, threatening to bankrupt self-funded health plans due to high demand. A year’s supply of Ozemic costs more than $10,000.

Cook’s Children’s Health Care System considers Reference Based Pricing plan members as SELF PAY!

“Your margin is my opportunity” – Jeff Bezos

Reference Based Pricing vendors make millions off hospital Charge-Masters while at the same time throwing stones at the high cost of health care.

The City of McKinney Human Resources Department is seeking an Employee Benefits Consultant to provide professional services related to the overall design and administration of the City’s employee benefits program.

Katie “I’m So Excited” Hopkins earns coveted Prick Loyalty Card after receiving 45th vaccine booster……

Victor Lustic Would Be Proud

“Here’s how drug diversion works: A patient fills a prescription for a medication that is worth several thousand dollars but is paid for by Medicare, Medicaid or insurance. The patient then sells it for a fraction of the list price in cash. The buyer, known as an aggregator, removes the patient information, alters the bottle and sells it to the wholesale distributor, who sells it back to the pharmacy.”

‘Jimmy the Crow” belonged to Hollywood animal trainer Curly Twiford who stole the bird from a nest in the Mojave Desert in 1934 ……

The company says they have hired nearly 20,000 doctors in 2023 alone, according to reports. It also counts an additional 40,000 advanced practice clinicians among its ranks.

Winston’s Rx Two Hat Method – Place hat on corner bedpost. Take a shot every two minutes until you see two hats. Upon awakening if you still have symptoms and see one hat, repeat process.

Who cares! My copay is only $25.

Vertex Pharmaceuticals and CRISPR Therapeutics co-developed the one-time treatment that could cost around $2 million per patient.

“PPO Discounts Are The Best”………………….I Don’t Agree.

By Allison De Paoli

Founder @ Altiqe | Turning Benefits Challenges into Strategic Success | Benefits Expert | Podcast Host | National Speaker

“Compounded Semaglutide Prescribed Online. Semaglutide is the same active ingredient in Wegovy®* and Ozempic®* for only $297 per Month.”

SOURCE: Semaglutide (Active Ingredient in Ozempic®), Prescribed Online (henrymeds.com)

Includes Provider & Medication and No Hidden Fees – No Insurance Needed

Posted on Linkedin by Chris Barakat

There is more than one way to transfer risk. Most plan sponsors think insurance coverage is the only method. They are wrong.

“This is the dirty secret of healthcare benefits… the ‘network’ provider is supposed to negotiate favorable pricing for healthcare services.  They don’t. This fallacy has been thoroughly debunked.  It’s just that not everyone is yet aware of this.”

“For average Danish citizens, Novo’s economic effect means a potentially better market for buying houses, cars and other big-ticket items.”

Independent agents compete against large national brokerage houses all the time. Marsh, Higginbotham, Gallagher, HUB, Willis and all the other Big Boys tout superiority over the little bitty guys in every community across the country. “We have internal resources your local broker doesn’t have” is their branded sales message.

SOURCE: HRA Council – Home

In June, the HRA Council released its 2023 data report on the state of Health Reimbursement Arrangements, including Qualified Small Employer HRAs (QSEHRAs) and Individual Coverage HRAs (ICHRAs). The report shows that between 2022 and 2023, the number of American workers offered insurance through an ICHRA tripled; QSEHRA offerings, only available to small employers with less than 50 employees, doubled.

SOURCE: Implementation of a Canadian Prescription Drug Importation Program | Colorado Department of Health Care Policy & Financing

The Federal Food Drug and Cosmetic Act (FDCA) Section 804 permits importation of prescription drugs from Canada by a pharmacist or wholesaler, provided the drugs meet certain minimum standards, will pose no additional risk to the public’s health and safety, and results in a significant reduction in costs to consumers. HHS can approve a program if these conditions are met.

PR Newswire – November 13, 2023·10 min read

• Continued year over year growth related to our acquisition of Maestro Health
• Further identification and implementation of synergies and opportunities continue as a result of the acquisition
• Veteran industry executive leadership announced along with the addition of a seasoned health care leader to strengthen the Board of Directors
• Focus on acceleration of operating efficiencies and customer growth

The Centers for Medicare & Medicaid Services’ (CMS’) Center for Consumer Information & Insurance Oversight (CCIIO) publishes the Individual Coverage Health Reimbursement Arrangement (ICHRA) Employer Lowest Cost Silver Plan (LCSP) Premium Look-up Table to help stakeholders access individual market Qualified Health Plans (QHPs) LCSP premium data by geographic location.

An Affordable Care Act mechanism intended to help small companies support ACA health insurance for workers is now being used by large companies to satisfy their ACA obligation to provide insurance to employees, under a Trump-induced loophole. They’re saving money, and selling it as enhancing choice.

The markup on drugs is phenomenal. Sensing a new business opportunity, RiskManagers has entered the pharmaceutical business as a self-declared Tylenol wholesale distributor serving hospitals across the Fruited Plains.

Plan Sponsor – “I’m supposed to do what?

Its amazing how many plan sponsors I’ve met have no clue what’s coming their way in less than 30 days from now. That’s really good news for plaintiff attorneys…………

You’re sitting at home wondering if you have a STD. So you head to your mailbox to leave a specimen.

Carlos Juan Finlay

National Doctor’s Day in Cuba – December 3, 2023

On December 3 every year, Cuban doctors celebrate their professional holiday. National Doctor’s Day in Cuba was established to commemorate the birthday of Carlos Juan Finlay, a Cuban physician and epidemiologist who was the first to discover the transmission vector of yellow fever.

ATTN. PLAN MEMBERS – Carry In Your Wallet or Purse At All Times

“Plan members (and the Plan) are completely indemnified against balance billing…….AMI Indemnity, an indemnity captive completely protects the plan and participant from additional legal or financial risk associated with a balance bill.”

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.”

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!

In 1907 the average life expectancy in the U.S. was 47 years old. Five leading causes of death in the U.S. were: 

By Paul MillerPaul Miller

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.

By John Petree – Nov 27, 2023

SOURCE: Opinion: TEE Is a True Disruptor and Here To Stay

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).

South of the line (USA) prescription drugs are more expensive than those purchased north of the line (CANADA).

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.

“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.”

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.”