Daily Insurance Report  
Walt Bernard Podgurski,  Editor,  440-773-1108, 

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.
  Monday, 08/19/19 - https://DailyInsuranceReport.com 

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The "Daily Insurance Report" publishes the life insurance, health insurance, and employee benefits news that matters.

Family healthcare spending now equals the cost of a new Harley-Davidson, report says
Maureen Groppe, USA TODAY

A typical family of four spends as much annually on health coverage as the cost of buying a Harley-Davidson, according to new analysis of rising health care costs.

Premiums and out-of-pocket costs reached $7,726 in 2018 for those with employer-provided coverage.

And when the employer's share of the health care costs is included, the family could have bought a Honda Insight for the overall $22,000 price tag.

That's according to the nonpartisan Kaiser Family Foundation, which combined data sources to show how much money families with employer coverage are actually spending on their premium contributions, deductibles and co-payments.

NXT  NXT Employee Benefits Investor Forum
Founders & Chief Executive Officers
  • Deliver your strategic investment and / or strategic partnership message to an audience of venture capitalists, private equity companies, angel investors, and the venture funds of banks and insurance companies.

  • The first event will take place at the University Club in New York City on November 12th.

  • Presenters bring a diverse spectrum of (employee benefits) technology expertise!

  • In addition to fintech and insurtech, presenting organizations include innovative and rapid growth product and service opportunities in the employee benefits marketplace.


$74.9 Million Paid in Employee Student Loan Benefits
Ralph R. Smith / fedsmith.com

Federal agencies are allowed to establish programs for repayment of various types of student loans in order to recruit or retain highly-qualified agency employees. A federal agency can make payments to a loan holder of up to $10,000 for an employee in a calendar year. There is an aggregate maximum of $60,000 for any single employee.

Employee Obligations

To receive this benefit, an employee must sign an agreement to remain employed by the agency making the payment for at least 3 years. If the employee leaves the agency voluntarily or is separated involuntarily for misconduct, unacceptable performance, or a negative suitability determination before fulfilling the service agreement, the student loan repayment benefits that were received have to be repaid.

According to a report from the Office of Personnel Management (OPM), agencies are using this legal authority to benefit federal employees.

About $75 Million in Benefits in One Year

In calendar year 2017, 34 Federal agencies provided 10,206 employees with more than $74.9 million in student loan repayment benefits. This is a 3.4 percent increase in federal employees receiving student loan repayment benefits compared to the previous year. It is also a 4.6 percent increase in agencies’ overall financial investment in this program.

Join Us For OE Week - August 19 - 23, 2019

It’s no secret that open enrollment is a lot of work for HR teams - from designing their benefits package to accounting for rising health care costs to planning employee communications, it’s easy to feel overwhelmed by everything that has to get done.

Resist the urge to give in to stress! Instead, get inspired, focused and motivated with PlanSource OE Week, five days of free 30-minute webinars held daily August 19-23 at 2pm ET (11am PT).

Each day during OE Week will feature a short, 30-minute webinar that’s packed with specific, actionable content that’s designed to help break down the process and focus employer efforts on planning and executing the best OE ever

Register here for all five webinars. If you can’t make it to all of them, don’t worry - we’ll send out a recording with the slides to all registrants afterwards.

The Healthcare Death Spiral That’s Waiting to Happen
By Chuck Muth , cnsnews.com

The bill, entitled the Lower Health Care Costs Act (LHCC), would ostensibly seek to resolve a prominent and ongoing healthcare crisis. But don’t let the bill’s innocuous name and seemingly noble purpose fool you. Just like Obamacare before it, the LHCC would only further destabilize America’s healthcare system. In doing so, it would increasingly justify the left’s push for government control. Undoubtedly, the LHCC is a healthcare death spiral waiting to happen.

To address the surprise medical billing crisis, the LHCC would impose government-mandated price controls across-the-board. Patients would only have to pay their in-network cost-sharing amount, even when they’re out of network. To accomplish this, however, the bill mandates that all out-of-network services be charged at a “median in-network rate.” And by linking the median in-network rate for services to the comparable Medicare price, the LHCC forces hospitals to accept lower fees.

While, at first glance, these changes may sound reasonable enough, a closer examination reveals just how dangerous the LHCC would be. The problem lies with the government’s price control metric—the median in-network rate. Basically, insurance companies can game the metric to increase their profitability, destabilizing the healthcare industry in the process.

Q2 Update

Year Round Benefit Administration

Exceptional Employee Engagement

Disproportionate Share Hospital Payments Clarified by the Courts
Craig Hasday, National Employee Benefits Practice Leader / LinkedIn

The court system has once again stepped into a seemingly clear case of abuse. It is common knowledge that Medicaid often pays providers less than the cost of their services and that hospitals are burdened with the cost of providing care for indigent uninsured patients who are unable to pay. In fact, the federal government provides funding to hospitals that have a large number of low-income and uninsured patients. Called Disproportionate Share Hospital (DSH) reimbursement, the formula pays those hospitals with the largest burden a greater reimbursement. In submitting requests for reimbursements, the rules had allowed hospitals to omit third-party payments that they might have received for these patients.

In 2017, the federal government introduced a policy that established that payments from Medicare and private insurers had to be considered and that under no circumstances could hospitals receive more than they spend for these patients under the DSH reimbursement rules.

Incredible to me, eight hospitals joined together to sue – alleging that Centers for Medicare & Medicaid Services (CMS) overstepped its authority – and a D.C. federal judge agreed. Thankfully, the U.S. Court of Appeals overturned the ruling earlier this week and upheld the requirement that all reimbursement be considered.

Private equity’s role in the future of healthcare
Investors are well-positioned to take advantage of industry’s changing landscape

Fifteen years from now, what will healthcare look like, and what types of companies will be delivering it? Will new technologies shape how we access healthcare? Will new companies emerge that will change the way healthcare is provided in response to patients’ expectations or statutory change? In many ways, the future is as clear as mud.

But there are certain things we do know.

Today, private equity investors consider much of the healthcare industry fragmented, operationally inefficient, and unresponsive to consumer preferences. These same traits, paradoxically, make healthcare highly attractive to private equity participation. Private equity firms are organized for the purpose of investing funds held by people and organizations with capital to put to work, and these investments are typically made in industries that are perceived as ripe for consolidation and managerial oversight.

Private equity consolidates assets and can vertically integrate previously separate organizations to create efficiencies. It uses capital and managerial skills to create greater value from sectors of the economy that are — as a recent article in The Economist described the healthcare system — “untouched by innovation, disruption and consolidation.”

If You Want Engaged Employees, Offer Them Stability
Marla Gottschalk / Harvard Business Review / ThinkAdviser

Most organizations struggle to find the right balance between stability and change, which in turn affects individual contributors. But in the race for innovation and digital transformation, the idea of stability has been somewhat lost in the mix, and there are strong indications that we should revisit its merits. If you want to develop an environment where contributors thrive, your workforce must be able to count on some basic things — such as role clarity, timely feedback, adequate resource allocation, and attention to how our work is structured.

401(k) Auto-Portability Could Boost Retirement Savings by Billions
BY TED GODBOUT / NAPA (National Association Of Plan Advisors)

Whether considered as a standalone policy initiative or in tandem with other legislation, implementation of auto-portability could reduce overall retirement savings deficits by hundreds of billions of dollars, according to a new study.

In “The Impact of Auto Portability on Preserving Retirement Savings Currently Lost to 401(k) Cashout Leakage,” the nonpartisan Employee Benefit Research Institute (EBRI) projects that as a standalone policy initiative, the present value of additional accumulations over 40 years resulting from “partial” auto portability applied to accounts with balances less than $5,000 would be more than $1.5 trillion.

Under “full” auto-portability – which would apply to all accounts regardless of the size of a participant balance – EBRI projects that the value would be nearly $2 trillion. What’s more, under partial auto-portability, those currently ages 25–34 are projected to have an additional $659 billion in retirement funds – increasing to $847 billion for full auto portability.

Small Employers: Look Before Leaping Into New MEP 401(k) Option
The MEPs' expanded rules may look advantageous but they still pose potential pitfalls that must be considered.
By Robert Bloink and William H. Byrnes

Final rules governing multiple employer plans (“MEPs”) are now on the table, leaving many small business owners wondering both what they should do to take advantage of the new rules and what they need to consider before jumping in.

Small business owners have a wide variety of retirement planning options to choose from, but the MEP is one that can offer the chance of minimizing the fiduciary risks and administrative expenses associated with providing employees with a 401(k) savings option. Despite the fact that the expanded rules may, at first glance, seem entirely advantageous, however, MEPs still pose potential pitfalls that must be considered—and employers should also consider the evolving retirement legislation proceeding through Congress before employers leap into MEPs.


Monday, 08/12/19 - Allscripts reaches $145M settlement with DOJ over subsidiary business practices

Tuesday, 08/13/19 - Experian buys MyHealthDirect, expands healthcare data footprint

Wednesday, 08/14/19 - Walgreen 401(k) Participants Seek $300M in Lawsuit Over TDF Mismanagement

Thursday, 08/15/19 - Going Without Health Insurance Can Double Your Risk of Bankruptcy

Friday, 08-16-19 - Employers now rank student loan assistance as the top new benefit they plan to offer during open enrollment this year,

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Walt Bernard Podgurski - - Editor