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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.
  Friday, 08/09/19 - https://DailyInsuranceReport.com 

The "Daily Insurance Report" is now subscribed to by 25,000 elite insurance industry influencers who receive it Monday - Friday and have a quick overview of what is appearing in the media regarding the insurance industry; with an emphasis on life, health, and employee benefits.

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

Short-Term Insurance Plans Pushed by Trump Spend Far Less on Medical Care
Yuval Rosenberg, The Fiscal Times / YAHOO FINANCE

Many of the short-term health insurance plans being promoted by the Trump administration spent a relatively small fraction of the premiums they collected last year on patients’ medical claims.

Modern Healthcare reports that the five health insurers that collected the most in 2018 premiums from short-term insurance policies spent just 39.2% of every dollar on medical care. The rest went toward administrative expenses or was kept as profit. The data was published last week in the National Association of Insurance Commissioners' 2018 Accident and Health Policy Report.

Under the Affordable Care Act, insurance companies are required to spend 80% of the money they take in from premiums on health care costs and quality improvement. Otherwise, they must pay rebates to enrollees. For comprehensive major medical plans purchased by individuals overall in 2018, the average ratio of medical payments to premiums collected was about 73%, according to the insurance commissioners’ report.

In contrast to Obamacare-compliant plans, short-term plans don’t offer as comprehensive benefits, and they can deny coverage to people with pre-existing medical conditions or charge sicker patients more.

As a result, they tend to be much cheaper — but their far lower spending on medical claims is “a stark reminder that short-term plans benefit insurance companies more than the patients who purchase them,” Modern Healthcare’s Shelby Livingston writes.



New Rule Allows Employers to Use Individual Coverage HRAs in Employee Benefit Programs
By Annette Bechtold

On June 13, the Departments of Health and Human Services (HHS), Treasury (IRS), and Labor (DOL) issued the final rule providing employers additional methods for using health reimbursement arrangements (HRAs) in their benefits program.
Building on the foundation of the October 29, 2018, proposed rule, this final rule permits employers to offer a new “Individual Coverage HRA” (ICHRA) as an alternative to traditional group health coverage.

Effective January 1, 2020, employers may set up an HRA to reimburse an employee’s individual health care premiums for coverage they purchase in the private market or through a state exchange. As with any other HRA, an employer chooses how much to fund for each employee annually. Employees will be able to use ICHRA funds to pay the premium for individual insurance coverage purchased either on or off the public Marketplace or to pay for Medicare premiums.

Alternatively, the rule also allows employers that offer traditional group health coverage to offer an “Excepted Benefit HRA (EBHRA)” to reimburse employees for certain medical expenses, and excepted benefits*, including stand-alone dental or vision benefits or premiums for Short-Term Limited Duration Insurance, unless precluded by the state.
Click here to download the Individual Coverage HRAs (ICHRAs) & Stand-Alone Excepted Benefit HRAs (SEBHRAs) Infobrief.

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.

4 pitfalls of paid leave and how employers can avoid them
By Angel Bennett / ebn

Smart employers are boosting their benefits packages with paid family leave — the most coveted work perk among all generations. In today’s low unemployment environment, paid leave benefits can be a huge differentiator in attracting and retaining talent.

But some employers are getting themselves into trouble in the process, facing accusations of gender discrimination or improper use of leave.

Here are four potential pitfalls of paid leave, and how employers can avoid them.

1. Be careful what you call “maternity leave.”
2. Don’t make gender assumptions.
3. Avoid assuming the length of disability.
4. Keep up with federal, state and local laws.


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.

Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets
Gretchen Jacobson, Rachel Fehr, Cynthia Cox / KFF (KAISER FAMILY FOUNDATION)

Key findings include:

Annual gross margins in the Medicare Advantage market averaged $1,608 per covered person between 2016 and 2018, about double the margins in the individual and group markets (E.S. Figure). Between 2016 and 2018, the individual market experienced substantial volatility, and the three-year average gross margins are not representative of any single year. In 2016, individual market insurers saw significant losses, and in 2018, margins were unusually high and plans were overpriced due to policy uncertainty.
When aggregated across all plans in this analysis, annual gross margins sum to $23.9 billion, $10.6 billion, and $26.5 billion for the Medicare Advantage, individual, and group markets, respectively, for 2016-2018.
Total medical expenses as a share of premiums collected (simple loss ratios) were similar for across the three markets between 2016 and 2018 (about 84-86%; E.S. Figure).

ES Figure: Annual gross margins in the Medicare Advantage market were about double the margins in the individual and group markets

Each of these three health insurance markets now appear to generate high gross margins per person, particularly for insurers of Medicare Advantage plans.

Paychex Again Ranks as Industry's Largest Provider of 401(k) Recordkeeping Plans
PR Newswire

For the ninth consecutive year, Paychex, Inc., one of the nation's leading providers in 401(k) recordkeeping services, has earned the distinction of being the retirement industry's leader in total number of defined contribution plans, serving 84,000 plans, more than any other provider in the retirement industry. The ranking was announced as part of the annual 401(k) Recordkeeping Survey published by PLANSPONSOR magazine, a national publication dedicated to the pension and retirement industry.

Why Your Employees’ Financial Wellbeing Affects Your Corporate Brand
William Arruda Contributor / Forbes

Eighty percent of employers report that financial stress is lowering their employees’ performance level, and it’s costing them some half a trillion dollars annually. Everything from home loans to student debt is stressing out America’s workforce; many workers don’t feel prepared to fully address these problems. Stress and anxiety cast a cloud over your self-confidence, making it hard for your unique talents to shine through.

What can managers do? Your first responsibility is, of course, to ensure that your company’s compensation packages are better than industry benchmarks, keeping pace with inflation and providing ample paths for upward mobility. But for workers at all pay levels, free financial coaching can be an HR benefit that delivers tangible added value. In fact, financial wellness has become the single most-asked-for benefit in 2019.

Everybody's Missing the Biggest Story in Washington — Our Debt Nightmare
All signs are pointing to higher taxes in the future. The middle class, especially those diligently saving for retirement in their 401(k)s and IRAs, need to be ready for that.

A lot of the noise coming out of Washington and the media really doesn’t matter. What does matter is the size of the mounting federal debt — over $22 trillion. And on top of that are the obligations to baby boomers for Social Security, Medicare and Medicaid – $60 trillion.

Nobody seems to care about it, but it’s a mathematical nightmare for our country over the next generation. We are borrowing at an ever-increasing rate, and at some point, the lenders will say, “No more.” And when you look at the developed economies — the countries that have money — you’ll see that they’re all in bad shape, too.

Doctor Alexa will see you now: is Amazon primed to come to your rescue?
Your Amazon Alexa-enabled smart speaker is poised to wriggle its way into all things health care.

At present, Alexa can perform a handful of health care-related tasks: “She” can track blood glucose levels, describe symptoms, access post-surgical care instructions, monitor home prescription deliveries and make same-day appointments at the nearest urgent care center.

Amazon has partnered with numerous health care companies, including several in California, to let consumers and employees use Alexa for health care purposes. Workers at Cigna Corp. can manage their health improvement goals and earn wellness incentives with Alexa. And Alexa helps people who use Omron Healthcare’s blood pressure monitor, HeartGuide, track their readings.

But a flood of new opportunities are emerging since Alexa won permission to use protected patient health records controlled under the U.S. privacy law known as the Health Insurance Portability and Accountability Act (HIPAA).


Monday, 08/05/19 - Views Zenefits’ founder is back: What does it mean for the billion-dollar HR tech market?

Tuesday, 08/06/19 - Trump administration considers September unveiling of healthcare plan: WSJ

Wednesday, 08/07/19 - Healthcare Blockchain Could Save Industry $100B Annually by 2025

Thursday, 08/08/19 - New survey finds health insurance not enough to protect employees against medical debt

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