Friday, 02/24/23

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Amazon Achieves Closing Of One Medical Deal, Officially Entering Doctor Clinic Business
Bruce Japsen, Senior Contributor / Forbes / Feb 22, 2023 / / Read Article

Amazon closed its $3.9 billion acquistion of One Medical, bringing the giant online retailer into the hotly competitive business of owning and operating primary care physician practices and clinics.

The deal means Amazon will now provide One Medical’s “in office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses, and mental health concerns,” the companies said Wednesday.

One Medical owns and operates more than 220 primary care offices in more than 28 U.S. markets. The sites include One Medical primary care offices, senior health offices specific for patients covered by Medicare, direct primary care clinics, and primary care offices for specific employee populations, the company said.

The rise of direct pay: a solution to the fragmented, impersonal and costly medical system

It used to be easy. You didn’t worry about your health care or how to pay for it. You had a family physician who cared for you in the office and the hospital. They coordinated every aspect of your care, including working with consultants. And after discharge, they would resume caring for you knowing what had occurred firsthand. That was then.

This is now.

Patients rarely see their primary care physician in person, if at all. The office is staffed by a number of nurse practitioners or physician assistants who assist in well-adult visits and acute care but do not assume full responsibility and are, therefore, less accountable. When a patient is admitted to the hospital, a hospital-based team takes over. If a specialist is involved, there is no longer any direct communication with the primary care. Once the patient is discharged, a summary of events is sent to the office. Those records are often never conveyed if the office is out of network or unaffiliated.

Which way is better?

It’s not surprising that when doctors worked together, the patients did better. But our system evolved into this impersonal, fragmented mess because of the administrative burdens — invented by payers and well-intentioned policy gurus — who sought to streamline an inefficient system.

5 Steps Toward Financial Wellness

American households that adopt some or all of five key financial wellness behaviors are more likely to be saving more and better positioned for building wealth, but “retirement savings” is one of the most difficult behaviors to adopt, according to the findings of a new report.

Hearts & Wallets’ “Household Finance: Quest for Liquidity, the Connection to Workplace Financial Wellness and the Current Competitive Environment” reveals that so-called Peak Accumulator behaviors, first identified by the organization in 2010, allow households to amass far more assets than groups with less financially healthy behaviors.

According to the research, 67% of Peak Accumulators save 10% or more of their income, more than double the national rate of 30% for U.S. households saving 10% or more in 2022.

Peak Accumulators have a national adoption rate of being “true” for the following behaviors in 2022:

“My insurance needs are covered (life, home, car, health)” – 66%
“I have little or no credit card debt” – 59%
“I have some savings in case I lose my job” – 54%
“I generally spend less than I make” – 51%
“I have a retirement savings plan(s) and I contribute to it/them regularly” – 43%

Nationally, only 19% of U.S. households do all five Peak Accumulator behaviors in 2022, but this is up 4 percentage points from 15% in 2011.

Healthcare costs were through the roof in 2022, and 2023 promises to be no different. In light of these challenges, many organizations are turning to Medical Expense Reimbursement Plans (MERPs): a proven alternative to traditional employer-provided health benefit plans, reducing both risk and unpredictability. That's why we're excited to share this handy guide to MERPs

Access Our MERP Guide For Brokers

What are MERPs?

MERPs are a broad categorization of different types of tax-advantaged reimbursement plans. Similar to traditional HRAs, they are vehicles through which employees can be reimbursed for eligible medical expenses.

What does this guide cover?

  • How MERPs differ from traditional plans

  • Why MERPs are often better than traditional plans for your clients

  • What makes Nonstop Health's MERP solution better than popular HRAs

Access the guide now for a deeper understanding of this innovative health benefit solution.

Chubb Launches First-Of-Its-Kind Personalized Genetics-Based Cancer Program
Chubb / Feb 22, 2023 / PRNewswire / / Read Article

Chubb Workplace Benefits (CWB), a Chubb business that partners with benefits brokers and consultants to offer voluntary benefits to the employees of middle-market and large companies in the U.S., has announced the launch of Cancer Advocate Plus, a first-of-its-kind cancer-specific, genetics-based insurance program. Cancer Advocate Plus provides tools and resources for an individual to proactively understand their risk of cancer, more effectively manage a cancer diagnosis, and offers insurance protection to help with the potential financial impact of a cancer diagnosis.

Cancer continues to impact Americans at substantial rates. One in two men and one in three women will be diagnosed with cancer during their lifetime. Early detection has proven critical as the five-year survival rate for early-stage cancers is 91.1% compared to 30.6% for late-stage cancers. The ability for average Americans to obtain cancer-related genetic testing has been challenging largely due to reimbursement, awareness, and cost issues. Chubb's Cancer Advocate Plus makes it accessible for today's workers.

"This program is unique. It meets Americans at the intersection of science, wellness and insurance coverage to help save lives," said Janet Buzil, Senior Vice President of Product Innovation at Chubb. "Cancer Advocate Plus offers a proactive and personalized approach to cancer risk recognition and care navigation one employee at a time. It is truly a game changer in the category of voluntary benefits."

What Long-Term Care Insurance Policyholders Need to Know
Thomas C. West, CLU®, ChFC®, AIF® / Kiplinger / 22 FEBRUARY 2023 / / Read Article

About 7.5 million Americans(opens in new tab) have some form of long-term care insurance (LTCI), which is a policy that helps cover the daily living costs associated with health diagnoses not covered by standard health insurance. This coverage is crucial to people who experience a health crisis that dramatically affects their way of living, such as Alzheimer’s or mobility issues.

Caring for Aging Parents Takes Planning Ahead and Patience

LTCI policyholders have significantly more options when it comes to housing or in-home health care than people who don’t. If you are lucky enough to have LTCI coverage, you may have questions about your policy. As someone who specializes in helping older adults prepare for their next phase of life, I’m often asked questions about LTCI. Based on some of the most common concerns I hear, I hope these insights below provide you with the necessary guidance to plan ahead for your future.

What Should I Do When My LTCI Premium Increases Each Year?
How much do you need to reduce your daily benefit to keep your premiums steady?
When Can I Start Using My Long-Term Care Insurance Policy?
Can I Use My Long-Term Care Insurance Policy If I Need Care at Home?
Why Do I Need to Worry About Long-Term Care Costs When I Have Long-Term Care Insurance?

Linking Long Term Care and Life Insurance Explained
Demand for long term care is growing and advisors can differentiate themselves and deepen client relationships through modern approaches to long term care planning.
Michael Konialian / / Feb 22, 2023 / / Read Article

Regulators are trying to address the increasing cost burden. In an effort to help more savers offset the cost of long term care, the IRS allows savers to deduct a portion of their LTC insurance premiums in excess of 7.5% of their adjusted gross income (AGI). LTC insurance benefits are also generally tax-free.

The federal government recently included a provision in the SECURE Act 2.0 that allows savers to use up to $2,500 per year of qualified dollars to pay for LTC insurance premiums. But the provision, while helping to offset the cost of insurance, may only cover part of the premium, which many savers are learning may also increase over time.

Local lawmakers have joined the effort. In Washington state, legislators passed, then delayed, a payroll tax that funded long-term care coverage for workers. California is exploring its own version of legislation, with lawmakers debating a tax increase to pay for benefits ranging from home care to “higher-range comprehensive” coverage. More than a dozen other states are exploring tax increases or mandates for LTC insurance. With more lawmakers exploring the topic, clients are likely to have ongoing questions about LTC.

U.S. Department of Labor / February 22, 2023 / / Read Article

The U.S. Department of Labor has recovered more than $3.1 million in back wages and fringe benefits for more than 3,100 workers at a California subcontractor that provided enrollment and dental and vision benefits support to federal employees, retirees and their dependents.

An investigation by the department’s Wage and Hour Division determined that Alorica Inc. in Irvine incorrectly paid workers prevailing wage rates and fringe benefit amounts less than those required by the McNamara-O’Hara Service Contract Act. The wage shortages occurred between January 2017 and March 2022.

“The Wage and Hour Division is committed to ensuring workers are paid the full wages and benefits they are rightfully due and that federal contractors are aware of their obligations under the Service Contact Act and comply with the law,” said Principal Deputy Wage and Hour Administrator Jessica Looman. “The vigorous enforcement of prevailing wage laws promotes efficiency and productivity in government by allowing agencies to recruit and retain talented federal contract workers.”

Owner Of Insurance Firm Pleads Guilty In $40 Million Scheme To Steal Client Healthcare Funds And Defraud Lenders
U.S. Attorneys » Southern District of New York » News » Press Releases
Department of Justice
U.S. Attorney’s Office
Southern District of New York / / Read Article

Damian Williams, the United States Attorney for the Southern District of New York, announced today that ANTHONY RICCARDI, an owner and manager of the Connecticut insurance firm Employee Benefit Solutions LLC (“EBS”), pled guilty today in White Plains federal court to conspiracy to commit wire fraud and bank fraud. Between 2015 and 2019, RICCARDI and his co-conspirators used EBS as part of a widespread, $40 million scheme to misappropriate and steal client healthcare funds and defraud multiple lenders. RICCARDI pled guilty today before United States District Judge Philip M. Halpern.

U.S. Attorney Damian Williams said: “Anthony Riccardi admitted today to leading a brazen, widespread scheme over nearly five years to abuse his position of trust by stealing millions in fiduciary money that was meant to pay for important employee healthcare expenses. To keep the scheme going, Riccardi also defrauded lenders out of millions. Thanks to the tireless efforts of our law enforcement partners to untangle this fraud, Riccardi will now be held accountable for these serious crimes.”

Crum & Forster Accident & Health Division Announces Acquisition of Partners MGU
February 21, 2023 / PRNewswire / Yahoo / / Read Article

Today, Crum & Forster (C&F) Accident & Health (A&H) announced the acquisition of medical stop loss insurance agency, Partners Managing General Underwriters LLC (PMGU), as the latest move in expanding its position in the self-insured marketplace.

C&F has been underwriting stop loss insurance for over 20 years and will continue to offer a broad suite of products and services on a direct and program basis through various distribution channels including managing general underwriters, managing general agencies, brokers and third party administrators. C&F's philosophy of diversification through its partners and unique industry segments has been a key factor in the success of the Accident & Health portfolio.

 the top 20 U.S. brokerages turn to AdminaHealth when it comes to billing for a reason.

Satisfied Customers February 2023

We find that billing errors are the #1 complaint to brokers.

 When you implement the AdminaHealth Billing Suite:

 Clients have no issues to report.

 Their rates are accurate. The carriers have accurate enrollment. Their employees are enrolled in and paying for the plans they chose.

 You sorted out all potential errors during Annual Renewal using automated reconciliation and helping clients clear errors displayed on their Exceptions Dashboards.

 Now you can focus on building your business and client relationships. Other brokers might be stuck untangling errors and fighting fires, but you are free to continue growing.

 Use the AdminaHealth Billing Suite to converge enrollment, payroll, and invoice data and then automate reconciliation, bypassing billing issues. Find and eliminate errors before they impact your clients!

 Join our February live demo to see why 11 of the top 20 U.S. brokerages turn to AdminaHealth when it comes to billing.

 Accurate Billing Satisfied Customers
AdminaHealth Billing Suite Live Demo
Tuesday, February 28, 2023
9 AM PT | 12 PM EST

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Photo Of The Day

Tuesday, 02/14/23 - - In an Uncertain Job Market, How Can Companies Retain Workers?

Wednesday, 02/22/23 - How Employers Can Hold The Healthcare Industry Accountable And Save Money In The Process

Thursday, 02/23/23 - - Healthcare is Moving to the Home. Are Health Plans Ready?

Friday, 02/17/23 - - Long Term Care: Protect Your Assets With An Annuity

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.
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