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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, 08/05/19 - https://DailyInsuranceReport.com 

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Views Zenefits’ founder is back: What does it mean for the billion-dollar HR tech market?
By Alex Tolbert / Employee Benefit Adviser

Parker Conrad is back and in a big way. Software luminaries gave him more than $500 million when he founded Zenefits to take the pain out of HR administration for small employers. Last month, he announced that a different set of software experts will invest $45 million in his new firm, Rippling.

Conrad is not the only entrepreneur to raise millions to pursue the small employer HR software market. Maxwell Health raised more than $50 million before being folded into the insurance company Sun Life and EaseCentral recently announced raising an additional $19 million while also changing its name to Ease.

All of this capital raising illustrates just how hot the benefits and HR technology market is — Grand View Research projects it will be worth $30 billion by 2025.

HR administration at U.S. businesses is largely still paper-based — especially at small and mid-sized organizations, which generally don’t have the ability or opportunity to invest in technology. Seeing this need, investors are funding companies to pursue the opportunity, giving employers more options to streamline HR administration.

Conrad’s new venture is representative of a greater shift in the HR market and the scope of ways vendors are serving the needs of small employers. But what do these shifts mean for HR customers and investors?

If you recently put an HDHP in place,
don’t wait for the HDHP/HSA issue!

To control benefit costs,
employers are turning to High Deductible Health Plans (HDHPs) and pairing them with HSAs to help fill the newly created coverage gaps. Clients and their employees are about to see if that combination will work—or whether it will have unintended ripple effects.

If you recently put an HDHP in place
or increased the deductible on an existing plan for any of your clients, it’s important to be prepared to handle issues that may soon come your way.

Don’t wait for the HDHP/HSA issue to erupt.
Download our infographic with the facts and solutions to create a game plan.

Five Common Misconceptions About Consumer-Directed Healthcare Arrangements
Martin Trussell Forbes Councils Member / Forbes

In a recent Policygenius survey of 2,000 American consumers living in the 10 largest cities, 96% failed to correctly define four essential health insurance terms: deductible, co-insurance, co-pay and out-of-pocket maximum. Among the survey findings:

As the executive director of an organization that advocates for consumer-driven health arrangements, I find this survey disturbing. Clearly, additional education is needed to help people understand the key provisions of healthcare plans -- terms everyone should know.

Like the basic terms of health insurance, many people struggle to define health savings accounts (HSAs), health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs), while miring themselves in misconceptions about these tax-advantaged benefits. The reality is that HSAs, HRAs and FSAs are effective budgeting tools for increased out-of-pocket healthcare costs, helping millions of Americans pay for the critical healthcare procedures that they otherwise may forgo.

With the 2020 open enrollment period coming up, let’s press the reset button on the education process by dispelling some common misconceptions consumers often have regarding consumer-directed healthcare arrangements, including HSAs, HRAs and FSAs.

1. HSAs and FSAs are the same.
2. HSAs are for people who have a lot of money.
3. Healthcare plans are complicated and require too much paperwork.
4. Employers cannot reimburse employees for individual health insurance.
5. These accounts don’t seem to help people very much.



New ‘Medicare for All’ Bill Would Kick 181 Million Off Private Insurance
Robert E. Moffit, The National Interest / YAHOO NEWS

New ‘Medicare for All’ Bill Would Kick 181 Million Off Private Insurance

The senator has just unveiled the Medicare for All Act of 2019 with 13 leading Senate Democrats, including fellow contenders for the 2020 Democratic presidential nomination: Sens. Cory Booker of New Jersey, Kirsten Gillibrand of New York, Kamala Harris of California, and Elizabeth Warren of Massachusetts.

Here are the specifics.

Outlawing Current Coverage

This bill, title by title and section by section, is almost identical in substance to the Medicare for All Act of 2017 (S.1804) introduced last Congress.

Under Title I, the bill would create a new national health insurance plan to provide universal coverage to all U.S. residents, regardless of their legal status. This new program would be phased in over a four-year period.

Under Section 107, the bill would outlaw private health coverage, including employer-sponsored coverage, that “duplicates” the coverage provided under the government health plan. Approximately 181 million Americans would lose their existing private coverage.


NXT Employee Benefits Investor Forum
Whether you are an investor seeking access to new deals, or founder and/or CEO of a new venture looking for funding, visibility and growth, this is a must-attend event.

NXT.Services is hosting seven one-day conferences in 2019 / 2020. Each event will feature the founders of 17 start-ups and SME's in the employee benefits space who are invited to present to 50+ venture capitalists, private equity firms, angel investors, and representatives from insurance carriers who have an internal venture fund and/or are seeking strategic relationships.

Rural hospitals struggle in states that declined Obamacare
By Michael Braga, Jennifer Borresen, Dak Le and Jonathan Riley / GateHouse Media / JDNews

More than half of all rural hospitals in Mississippi, South Carolina, Georgia and Oklahoma lost money from 2011 through 2017.

In Kansas, the bloodletting was even more widespread.

Two out of three rural hospitals in the state operated in the red during the seven year period.

What these states also have in common is that legislators voted against expanding Medicaid under the Affordable Care Act, which would have provided coverage for hundreds of thousands of uninsured residents and bolstered rural hospital bottom lines.

Fiercely conservative and inherently distrustful of the federal government, state politicians balked at picking up 10 percent of the Medicaid expansion tab and repeatedly expressed fears that Washington bureaucrats would renege on generous Obamacare funding, leaving states to cover an ever increasing share of the healthcare burden.

That hasn’t happened yet.

In the meantime, residents of deep red rural America — farmers and farm workers, small business owners and their employees, the old and irfirmed — are seeing their hospitals founder and close.

Smart Benefits: IRS Announces 2020 ACA Affordability Threshold
Rob Calise, GoLocalProv Business/Health Expert

Under the Affordable Care Act’s (ACA) employer mandate, Applicable Large Employers (ALEs) – generally those who had 50 or more full-time employees, including full-time equivalents, in the prior year – may be subject to a penalty if they do not offer affordable coverage that provides minimum value to full-time employees and their dependents.
Affordability Threshold

For plan years beginning in 2020, the IRS has announced that coverage will generally be considered affordable if the employee’s required contribution for the lowest cost self-only health plan offered is 9.78% or less of his or her household income for the taxable year. The IRS has created three safe harbors that employers may use in place of the employee’s household income to determine affordability:

Rate of Pay
Federal Poverty Level

ALEs may be subject to a penalty for (1) failure to offer coverage to all full-time employees and their dependents – the “part a” or “failure to offer” penalty; or (2) offering coverage that is not affordable or does not provide minimum value – the “part b” penalty.

Striking down the individual mandate still matters

In his argument earlier this month before the Fifth Circuit Court of Appeals, Texas Public Policy Foundation’s Robert Henneke once again demonstrated how Obamacare’s individual mandate provision harms hard-working, law-abiding citizens. (Full disclosure: I too work for the Texas Public Policy Foundation.) Henneke represents individuals who continue to be injured by the Affordable Care Act — working Americans whose health insurance premiums have skyrocketed, who have lost the doctors of their choice, and who now suffer rationed health care access.

Despite contentions from some that striking down the mandate would be of little practical consequence, the resulting real-world benefits to everyday people have become increasingly apparent. Less appreciated, however, is the momentous impact that such a decision would also have within the legal sphere.

One of the fundamental issues lying at the heart of this case is the degree to which respect for the rule of law is essential to maintaining a free society. Many have claimed that the penalty for noncompliance being lowered to zero now means that there’s no harm in the government telling people what insurance they must buy. After all, they contend, those people can simply choose to ignore what the statute unambiguously tells them to do.

But a lack of punishment does not excuse someone from his or her legal duties. And “lawfully” disobeying the law is an oxymoron. Claims to the contrary end up amounting to little more than advancing the old — and deeply flawed — saying, “it’s not illegal if you don’t get caught.” Everything in our legal tradition tells us that such sentiments do nothing to secure the blessings of liberty, but instead invite in the afflictions of anarchy.

Other voices: The fate of the Cadillac tax should be a wake-up call

The U.S. House of Representatives voted this month to repeal a key piece of Obamacare. Hadn’t heard? That’s because hardly anyone in either party uttered a peep of concern; the repeal passed by a whopping 419-to-6 margin. The provision in question was the so-called Cadillac tax on overly generous health-care plans, designed to keep costs down even as more people got coverage, which was set to phase in three years from now. The repeal action moves to the Senate, where there is wide support. Repeal would cost the treasury $197 billion over a decade, according to the Congressional Budget Office.

The hypocrisy flows almost as copiously as the red ink. Democrats were happy to argue, when the Affordable Care Act was still a bill and not a law, that its coverage expansion would come hand in hand with long-needed cost containment. Now, they are happy to turn around and gut the cost containment. Republicans pretended great concern about the deficit, then two years ago passed a budget-busting tax cut, and now enable yet more deficit spending. They failed to repeal Obamacare, but, with the complicity of Democrats, they will likely repeal a crucial section that made it fiscally responsible. And where are the former Obama administration officials as their party evinces this Cadillac tax cowardice?

Record sealed in woman's disability denial claim against Life Insurance Co. of North America

An order sealing the administrative record was filed in a case alleging a woman's long-term disability benefits were wrongfully denied.

The order states that administrative procedures need to exercise caution when pleadings, documents and exhibits contain personal identifying numbers, medical records, employment history information, individual financial information or proprietary or trade secret information. The order also states that the personal data identifiers and other confidential information contained in the administrative record, particularly the medical records and employment information, are essential to the court’s review of the case and cannot be feasibly redacted from the record, which is good cause to allow the administrative record to be filed under seal.

Millennials aren’t thinking about this risk to their finances
Mallika Mitra / CNBC


If you’re young and without children, the need to purchase it can seem far off. Procrastinating will cost you.

Life insurance isn’t just for parents. Married couples and student loan borrowers with cosigners might also need coverage.

Purchasing life insurance? Here are a few things to consider.

How Pacific Life lost its bet on socially minded millennials

In 2017, Pacific Life Insurance Co. introduced a socially conscious, online investing platform tailored to thirtysomethings eager to use their assets to make the world a better place. Those investors proved more expensive and rare than the company thought, and less than two years later, the venture is returning their money and shutting down.

The company, called Swell Investing, tweeted Wednesday that it will close Aug. 30. In surveys, people in their 20s and 30s say they’re eager to invest in line with their values, but the short life of Swell suggests that the financial services industry has been wrong about how ready they are to do so.

USI Buys Wexford Employee Benefits Firm JRG Advisors
By Jayne Gest / SMART BUSINESS Dealmakers

USI Insurance Services has acquired JRG Advisors LLC, a Wexford-based employee benefits services firm.

The company’s existing operations will be combined with Emerson Reid, USI’s employee benefits wholesale brokerage division, as part of a plan to strengthen Emerson Reid’s footprint and expertise in western Pennsylvania and Ohio.


Monday, 07/29/19 - Anthem Launches New Consumer App

Tuesday, 07/23/19 - Research: Student loan assistance emerges as top new benefit option for open enrollment

Wednesday, 07/24/19 - Is forced telemedicine the future of healthcare?

Thursday, 07/25/19 - Industry Voices—How the future of healthcare will be shaped by the likes of Uber, CVS

Friday, 07-26-19 - Insurance Agency Mergers and Acquisitions in First Half of 2019 Shatter Record, OPTIS Partners Reports

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Walt Bernard Podgurski - - Editor