Daily Insurance Report  
Walt Bernard Podgurski,  Editor,  440-773-1108, 
Walt@DailyInsuranceReport.com

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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, 08/12/19 - https://DailyInsuranceReport.com 

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


Allscripts reaches $145M settlement with DOJ over subsidiary business practices
Rebecca Pifer / HEALTHCARE DIVE

Dive Brief:

Allscripts sells EHR, financial and population health management platforms to providers and healthcare facilities. It acquired Practice Fusion, another EHR company, in January for $100 million, roughly a year after Practice Fusion was informed a district attorney in Vermont was looking into its compliance with the EHR certification program.

The DOJ began investigating Practice Fusion prior to Allscripts' acquisition over "actions that occurred prior to our ownership," Allscripts president Rick Poulton said on a Thursday call with investors. "As such, we were highly motivated to close this with the DOJ."

For the full quarter, Allscripts paid $154 million in transaction and legal costs, mostly related to the agreement. In contrast, in the second quarter last year, Allscripts spent only $43 million.

Several EHR vendors have gotten into trouble with the government for allegedly falsifying certifications and provided kickbacks to clients in exchange for promoting their products to other companies. In May 2017, Allscripts competitor eClinicalWorks settled with federal prosecutors for $155 million — the first time the DOJ pursued an EHR vendor for falsifying Meaningful Use certification.


OPEN ENROLLMENT
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.



Oregon governor signs off on paid family and medical leave bill
BY ARIS FOLLEY / TheHill.com

Oregon Gov. Kate Brown (D) signed legislation Friday that gives residents 12 weeks of paid family and medical leave and offers low-income workers full wage replacement benefits in a historic first, The Oregonian reported.

House Bill 2005, which is being hailed by backers as the country’s "most progressive" family leave policy, will allow workers to will receive up to 12 weeks of paid time off that can be “used to care for a new baby, recover from a serious illness, or support newly adopted or foster children,” Brown’s office said in a release.

The office also added that the bill will provide victims of domestic violence with paid time off and “guarantees 100% of wages to low-income workers.” According to The Oregonian, the legislation makes Oregon the first state in the nation to offer low-income workers full wage replacement benefits.



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.



CVS’ Aetna Targets 4 In 5 Medicare Seniors For Advantage Plans
Bruce Japsen, Senior Contributor / Forbes

Aetna's Medicare Advantage membership is up more than 400,000 enrollees this year to 2.2 million as of the end of the second quarter compared to the end of 2018 when the company reported 1.75 million Medicare Advantage members.

This fall will be the first open enrollment period with Aetna and CVS as a combined company following its merger late last year and executives are ramping up their effort to reach more seniors with 2020 Medicare Advantage benefit packages during what may be the most competitive market in years among insurers. “We'll provide coverage access to about 80% of Medicare eligible lives,” CVS Health chief executive Larry Merlo told analysts on the company’s second quarter earnings call Wednesday.

CVS and Aetna executives are enticing seniors for 2020 enrollment in Medicare Advantage plans with new benefits that will feature “zero” co-payments for treatments and services at their more than 1,100 MinuteClinics staffed by nurse practitioners. The health insurer is also planning to integrate more health services at new “Health Hub” location stores that CVS is rolling out over the next three years.




CommonCensus®

BENEFIT ADMINISTRATION
COMPARISON
 
DARE TO COMPARE





Sanders Demands Drug and Insurance Industries Explain the Hundreds of Millions They Seem Willing to Spend to Defeat Medicare for All
"You made a $100 billion in profits last year—how much are you going to be spending of that $100 billion to oppose Medicare for All? Is it $200 million? Is it $500 million? Is it a billion dollars in order to protect your profits?"
byJon Queally / Common Dreams

Democratic 2020 presidential candidate Bernie Sanders is calling on the top lobbyists of the nation's private health insurance and pharmaceutical industries to explain to the American people why they are willing to spend hundreds of millions of dollars this election cycle to attack his proposal for Medicare for All—a plan that would provide everyone in the country with healthcare coverage by improving and expanding the existing Medicare program.

In a letter sent Friday to Matt Eyles and Stephen Ubl, the respective heads of America's Health Insurance Plans (AHIP) and the Pharmaceutical Research and Manufacturers of America (PhRMA), Sanders asked them both to "please explain to the American people why you believe it is more important to spend such an enormous sum of money on advertising, lobbying and campaign contributions than it is to make sure that no one in the wealthiest country in the world dies or goes bankrupt because they cannot afford to purchase life-saving prescription drugs or go to a doctor."



 
NXT  NXT Employee Benefits Investor Forum
WHAT WE DO
  • NXT brings together people and companies in the employee benefits, insurtech, and fintech space, that need and want funding, with people and organizations capable of providing the funding, including; venture capitalists, private equity, angel investors, and venture funds from insurance companies and banks.
HOW WE DO IT
  • NXT utilizes their network of specialized contacts and other resources to find early stage and medium size “investible” businesses.
  • We create opportunities for the founders and leaders of those organizations to deliver their message to people who may want to invest in them.
  • This is accomplished primarily through 1-day events held regionally across the U.S., including; New York, Silicon Valley, Miami, Austin, Boston, Chicago, and Los Angeles.

LEARN MORE AT NXT.SERVICES




LINDSEY GRAHAM SAYS REPUBLICANS WILL TRY TO "REPEAL AND REPLACE" OBAMACARE—AGAIN
BY NICOLE GOODKIND

Republican Senator Lindsey Graham outlined Republican priorities in 2020 if they win back the House this week. High up on that list? Another attempt to "repeal and replace" the Affordable Care Act.

"This is what 2020 is about. If we can get the House back and keep our majority in the Senate, and President Trump wins re-election, I can promise you not only are we going to repeal Obamacare, we're going to do it in a smart way where South Carolina will be the biggest winner," Graham told conservative radio host Joey Hudson on Monday. "We've got to remind people that we're not for Obamacare."



KERR: Expanding Medicaid is helping to make Virginia healthier
By David S. Kerr / INSIDENOVA

There were lots of disappointments, but with persistence and endless lobbying, the Virginia General Assembly did something amazing last year. With almost unanimous Democratic support (Democrats had been pushing this change for years) and a strong Republican crossover Virginia finally signed up to the expanded Medicaid provision of the Affordable Care Act. This was monumental for the commonwealth. The Affordable Care Act has a provision that allows states to expand their Medicaid programs, with the federal government footing 90% of the bill. Its purpose is to expand healthcare to the nation’s working poor.

Now, just to backtrack. Medicaid and Medicare are easily confused. Medicare provides healthcare for people age 64 and above. Medicaid is a state managed, state and federally supported program, that provides medical care to the indigent. However, to qualify for Medicaid a person needs to be below the poverty level. A determination based on income and family size. Ah, but there is always a Catch-22. Many people in Virginia weren’t prosperous enough to pay for Obamacare insurance and at the same time weren’t poor enough to qualify for Medicaid. So, they had no coverage at all.



Within the healthcare industry, even high wage-earners are often financially fragile
Doctors need long-term disability insurance
Michael Miller

Despite a relatively rosy economic picture with low unemployment, a healthy stock market, and solid housing gains, many of the nation’s most compensated workers are often struggling. According to a 2018 poll of U.S. workers by employee benefits company Unum, 49 percent have less than $1,000 in savings and could only pay bills for about two months before needing additional assistance. Of those making more than $100,000 per year, 40 percent are living paycheck-to-paycheck.

This is worrying in many respects, but particularly so in the context of disability. When a household’s breadwinner can’t earn a paycheck, it may be difficult for a family to keep up with everyday expenses.
Unfortunately, suffering a disabling injury or illness is more common than many people think: According to the Social Security Administration, one in four U.S. workers will experience a disability requiring more than a year away from work during their career.



Montefiore St. Luke's Cornwall Partners with Tuition.io for New Benefit Allowing Employees to Exchange PTO for Student Loan Repayment
PRNewswire

Montefiore St. Luke's Cornwall (MSLC) recently announced a new benefit designed to help employees pay off their staggering student loan debt. As part of the Student Loan Repayment Program, MSLC employees can convert unused paid time off (PTO) into employer contributions toward paying down their student loan debt. The program is being administered by Tuition.io, the leading platform for employee student loan contributions.

As part of MSLC's Student Loan Repayment Program, employees can transfer their unused PTO to the repayment of their student debt, including federal and Parent PLUS loans. Eligible employees can convert 30 to 75 hours of unused PTO into payment against student debt which will be distributed semi-annually with a maximum of $5,000 in annual contribution. The program is now available to full-time and part-time employees.



DOL Eases Automatic Transfer of Left-Behind 401(k) Dollars to New Plans
A new twist on auto-portability helps preserve employees' retirement savings
By Stephen Miller, CEBS / SHRM

New guidance from the Department of Labor (DOL) should make it easier for employers to transfer former employees' small-balance 401(k) funds to their new employer's 401(k) plan, as long as the employees do not opt out of the transfer. The exemption removes a requirement that 401(k) participants consent to having a balance of $5,000 or less rolled into their new employer's plan.

Currently, employers, as 401(k) plan sponsors, can automatically roll over a former employee's 401(k) balance of up to $5,000 to a safe harbor individual retirement account (IRA). The new guidance, however, allows employers to participate in an automatic portability program that goes a step further and ultimately transfers small-balance 401(k) funds to an ex-employee's new 401(k) plan.



iPipeline to Be Acquired by Roper Technologies
Larry Berran Appointed as CEO
BUSINESS WIRE

iPipeline®, a leading provider of cloud-based software solutions for the life insurance and financial services industry today announced that it will be acquired by Roper Technologies, Inc, a diversified technology company and a constituent of the S&P 500, Fortune 1000, and the Russell 1000 indices. The acquisition is expected to close in the third quarter, subject to regulatory approval and customary closing conditions. iPipeline also announced the appointment of Larry Berran as CEO.

Roper has a successful history of acquiring well-run technology companies in niche markets that have strong, sustainable growth potential. iPipeline’s track record of profitable growth and leading position within its core markets make it an excellent fit for Roper’s long-term strategy.



9 Health Insurance Acronyms Small Business Owners Should Know
by Barbara Weltman / Small Business TRENDS

Many health insurance acronyms float around these days. In the past, people counted on essentially two health care options. They included traditional group health insurance and, for seniors, Medicare. Today, you’ll find a number of health care options. Some of which specifically limit themselves to small businesses. The array of options may confuse you because of the many names used to describe them.

Check out this list of health insurance acronyms that you need to know:

ACA (Affordable Care Act)
AHPs (Association Health Plans)
ALEs (Applicable Large Employers)
COBRA (Consolidated Omnibus Budget Reconciliation Act)
EBHRAs (Excepted Benefit Health Reimbursement Accounts)
HDHPs (High-Deductible Health Plans)
HSAs (Health Savings Accounts)
ICHRAs (Individual Coverage Health Reimbursement Accounts)
QSEHRAs (Qualified Small Employer Health Reimbursement Accounts)



  Archives

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, 08-09-19 - Short-Term Insurance Plans Pushed by Trump Spend Far Less on Medical Care


Contact Us
Walt Bernard Podgurski - - Editor
440-773-1108
Walt@DailyInsuranceReport.com