Daily Insurance Report
Tuesday 04/20/21 Walt Podgurski 440-773-1108 E-Mail
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Reimagining the Future Of Insuretech In 2021
Chirag Buch, Managing Partner / SE2 India / / Read Article

The Global Insurtech Market revenue is valued at $5.48 billion in 2019 and is expected to reach $10.14 billion by 2025. The industry now appears to be at a key transformation point with many experts viewing the digitization of insurance as the next big opportunity after fintech. There is a shift in the global insurance market where companies with legacy infrastructure are adapting to a more digital-first business model approach and are in the process of application modernization.

While the main challenge of many insurance carriers seems to be addressing an increasingly digital-savvy customer, many carriers also are under pressure of delivering to these customers while maintaining expensive legacy systems and launching new products. The pandemic also played a big role in nudging many insurers to fasten their digital transformation efforts and approach insuretech companies to enable reliable end-to-end operations management, increasing virtual interactions in sales and claims, as well as reduce frauds and risks.

Sun Life launches Stitch® to expand access to supplemental health benefits
Offering reaches part-time, contract, and gig-workers
PRNewswire / / Read Article

Sun Life has launched a new, comprehensive way for employers to offer supplemental health benefits to all of their employees, including part-time and gig workers who typically are not eligible for benefits. Stitch, an innovative solution fully administered by Sun Life, gives employees access to Sun Life's broad portfolio of supplemental health benefits and an experienced team of benefits counselors and licensed agents, with zero administrative work for the employer. Employees can purchase their benefits online or via mobile at any time of the year and take the insurance with them if they leave their jobs.

Supplemental health benefits pay members directly if they have an accident, experience a critical illness such as cancer, stroke, or heart disease, or are hospitalized for several days. The lump-sum payments can be used for anything the member wishes, from medical bills to mortgage payments. These benefits help close the coverage gaps in health insurance by cushioning the out-of-pocket financial burdens that can accompany a major health event.

"Many employees, whether full- or part-time, often don't have access to the benefits that complement health insurance and help reduce financial risk," says David Healy, senior vice president, Group Benefits at Sun Life U.S. "With Stitch we are broadening access to supplemental health benefits by eliminating the administrative work for employers, making the benefits available to a wider range of employees, and making it easier for them to enroll, ask questions, and even take it to their next job."

Often people are not aware of the potential out-of-pocket expenses associated with an accident or major health diagnosis. Deductibles, out-of-pocket maximums and co-insurance can add up to thousands of dollars, creating pricey gaps in healthcare coverage. The Kaiser Family Foundation research on deductibles showed an average in each state ranging from $2,800 to over $4,000 per year for a family. Stitch includes useful information and real-world examples to help employees navigate their benefits decisions and choose a plan that is specific to their needs.

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Alight Solutions AI platform helps employers gauge benefit use
By Amanda Schiavo / / Read Article

Alight Solutions, a cloud-based digital human capital and business solutions provider, has debuted an artificial intelligence platform designed to make interactions between HR and employees easier.

The platform will help employees engage with their benefits and give employers access to important analytics to better understand and support employees. About 88% of global employers use AI in some way for their HR functions, according to the Society for Human Resource Management. Eighty-three percent of U.S. employers rely on technology in some way for HR management.

Through Alight Worklife, employers can provide employees with access to a suite of web-based tools through the Alight mobile app. The platform will use AI data to send personalized HR and benefits recommendations to employees based on their current personal circumstances.

Biden administration rescinds Trump’s extension of Texas’ $100+ billion Medicaid program
Wes Rapaport / kxan/ NBC / / Read Article

The Biden administration removed a Trump-approved extension for Texas’ Medicaid program, explaining the federal government “materially erred” in granting the state’s request for a sped-up extension.

A spokesperson for the Centers for Medicare & Medicaid Services confirmed CMS erred in exempting the state from the normal public process, which the spokesperson described as a critical priority for soliciting stakeholder feedback and ensuring public awareness.

Texas is one of 12 states that has not adopted federal Medicaid expansion. Instead, through what’s known as a Medicaid 115 waiver, Texas was approved to run its Texas Healthcare Transformation and Quality Improvement Program tapping into federal and state funding. The program is worth worth more than $11 billion per year, according to the Texas Hospital Association.

Relatively Few Drugs Account for a Large Share of Medicare Prescription Drug Spending
Juliette Cubanski and Tricia Neuman / KFF / / Read Article

Policymakers are once again focusing attention on proposals to lower prescription drug costs. During the previous session of Congress, the House passed legislation (H.R. 3) to allow the federal government to negotiate drug prices for Medicare Part D, Medicare’s outpatient prescription drug benefit, and private insurers.

Under H.R. 3, the HHS Secretary would negotiate prices for up to 250 brand-name drugs lacking generic or biosimilar competition with the highest net spending. In contrast, other drug price negotiation proposals placed no limit on the number of covered drugs subject to negotiation. In a similar vein, the Trump administration issued a final rule to establish a model through the CMS Innovation Center that would base Medicare’s payment for the 50 highest-spending Part B drugs (i.e., drugs administered by physicians in outpatient settings) on the lowest price paid by certain other similar countries. (In light of pending litigation, the Biden Administration has stated that it will not implement this model without further rulemaking.)

These drug pricing proposals raise the question of whether limiting the number of drugs subject to government price negotiation or international reference pricing might leave substantial savings on the table, even if this approach is more administratively feasible than subjecting all drugs to negotiation or reference pricing.

Level raises $27M from Khosla, Lightspeed ‘to rebuild insurance from the ground up’
Mary Ann Azeved / / Read Article

Level, a startup that aims to give companies a more flexible way to offer benefits to employees, has raised $27 million in a Series A funding round led by Khosla Ventures and Lightspeed Venture Partners.

Operator Collective and leading angels also participated in the financing, along with previous backers First Round Capital and Homebrew. The round was reportedly raised at a “nine-figure” valuation, but the company did not provide more specifics.

Founded in 2018, New York City-based Level says it’s “rebuilding insurance from the ground up” via flexible networks and real-time claims with the goal of helping employers and employees get the most out of their benefit dollars.

Employers can customize plans to do things like offer 100% coverage across treatments. The company also touts the ability to process claims in four hours.

Telehealth Experiences Company SteadyMD Raises $25 Million
By Amit Chowdhry / PULSE 2.0 / / Read Article

SteadyMD — a technology company and healthcare provider that delivers high-quality telehealth experiences in all 50 states — recently announced a $25 million Series B capital raise to enhance the company’s platform services that now power the telehealth infrastructure of digital health businesses and employers. Lux Capital led the funding round with Partner Deena Shakir joining the SteadyMD Board of Directors and additional participation from Ashton Kutcher and Guy Oseary’s Sound Ventures, Acrew Capital, and other healthcare investors.

The new funding round comes after 5 years of strong growth within SteadyMD’s proven direct-to-consumer primary care offering and will support the recent expansion of its platform services – which enable telehealth providers across the care continuum to scale with a 50-state clinician workforce, legal and regulatory guidance, and supporting technology.

Tomorrow Health Raises $25 Million Series A Financing to Deliver Seamless Home Healthcare at Scale
PRNewswire / / Read Article

Tomorrow Health, the leading patient-first platform for home healthcare, today announced it has closed a $25 million Series A round of funding led by Andreessen Horowitz with participation from Obvious Ventures and BoxGroup. The company will utilize the new capital to hire additional talent and expand its infrastructure technology to seamlessly connect every patient with home-based care. In addition, the company announced Paul Mango, former Deputy Chief of Staff for Policy at HHS and Roy Beveridge, former Chief Medical Officer at Humana, have joined its Advisory Board.

With one in four aging people using durable medical equipment (DME) and 10 percent of COVID-19 patients experiencing ongoing symptoms, spending on DME is expected to reach more than $75B by 2021 in the United States. Tomorrow Health enables patients to get the equipment and supplies they require at home in a streamlined manner with accuracy, speed, and exceptional service. Partnering with payors, referring providers, and DME suppliers, Tomorrow Health provides a data-driven intelligence platform to match patients with high-quality DME suppliers based on insurance coverage, service quality, geography, and product specialization. Its dedicated team of Care Advocates offer support throughout the process, ensuring equipment and supplies are delivered when and where they are needed, with high-quality service and product transparency and education guaranteed every step of the way.

BrightPlan Closes $9.5 Million Series A Round as Growth Accelerates
BrightPlan / / Read Article

BrightPlan, a leader in Total Financial Wellness, today announced that it has closed a $9.5 million Series A funding round led by the Fremont Group and the Cynosure Group, and joined by Still Capital Partners and Hawk Partners. The investment comes on the heels of a year of strong growth for the company, which saw a nearly fivefold increase in annual recurring revenue awarded and several new enterprise customers in 2020, including Genesys and Rubrik. As part of the investment, George Still, Jr., a well-known tech investor and board member for Workday, joins the BrightPlan Group, Inc. board of directors. This round will drive expansion and continued product innovation for the BrightPlan platform, enabling positive financial outcomes for enterprises and their employees.

Today employers increasingly seek solutions to improve employee well-being and foster engagement. Finances are the top stressor of employees according to PwC, and research has found a direct link between financial stress and physical and mental health. In addition, many organizations are focused on improving equity across the workplace. BrightPlan’s Total Financial Wellness solution integrates with employer benefits to provide a comprehensive personal finance solution for all employees that is real-time and personalized, helping all employees manage financial stress while improving productivity, engagement and retention.

As part of its ongoing commitment to innovation, BrightPlan also unveiled a redesigned AI-powered solution that provides deeper personalization for employees and makes it easier to set and accomplish tailored financial goals. The new user dashboard provides deep financial insights and enhances ease of use, elevating the most salient financial data to help employees set priorities, make more informed decisions and quickly take action to achieve any life goal―from paying off debt to purchasing a home to planning for retirement.

Exude, Inc. Announces Acquisition of Benefits Strategies Consulting, Inc.
PRNewswire / / Read Article

Exude, Inc., a consulting firm specializing in Employee Benefits, Human Resources, Diversity/Equity/Inclusion, and Training & Development, is excited to announce the acquisition of Benefits Strategies Consulting, Inc. in Pottstown, PA.

Benefits Strategies Consulting, Inc., is an independent health broker with over 27 years of experience, representing mid-sized employers in the Delaware, Lehigh and Lancaster Valley areas.

"We are excited to welcome our newest clients to the Exude family and look forward to providing 24/7 customer service and exceptional consulting to create the best possible benefits programs for their employees," said Marcos Lopez, Founder and CEO of Exude.

Photo Of The Day

Monday, 04/19/21 - - Report to Congress - Annual Report on Self-Insured Group Health Plans

Tuesday, 04/13/21 - -
People are flocking to the reopened Obamacare marketplace — and finding deals

Wednesday, 04-14-21 - - Health care for $1 a month? Covered California touts massive subsidies from COVID relief

Thursday, 04-15-21 - - 
98% of leaders plan to change employee benefits post-pandemic: 5 details

Friday, 04-16-21 - -
WEX agrees to acquire Illinois benefits administration company for $275M

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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.