HealthSherpa helps nearly 700,000 people access $4.3 billion in subsidies in first two weeks of Open Enrollment
By Aleka Gürel / HealthSherpa / / Read Article

Note to Media: We can provide state-level aggregate data for categories shown here for states where HealthSherpa offers ACA-subsidized policies. Please reach out if you’re interested in additional data.

Two weeks into open enrollment, HealthSherpa has already helped more than 600,000 people enroll in quality, affordable health coverage for 2022. More excitingly, 97% of enrollees have qualified for a subsidy and most will pay less than $20/month for their plan. In total, HealthSherpa has already helped enrollees access more than $4.3 billion in subsidy for 2022.

Column: She was billed $809 for a boot for her broken foot. Amazon charges $80
BY DAVID LAZARUS, BUSINESS COLUMNIST / Los Angeles Times / / Read Article

Wait, $80? And UCLA billed her more than $800? A nearly 1,000% markup?

“I assumed the price on my bill had to be a typo,” Drachkovitch said. “It had to be.”

It wasn’t.

Drachkovitch said a UCLA service rep looked into her bill and, you guessed it, no typos. The Thousand Oaks clinic was seriously, actually charging $809 for something you can buy online for a small fraction of that cost.

This is all too typical of the $4-trillion U.S. healthcare system, which charges the world’s highest prices for treatment and forces Americans to pay roughly double what people in other developed countries pay for care.

Not coincidentally, a 2019 study found that medical bills were a primary factor in about two-thirds of U.S. personal bankruptcy filings. More than half a million U.S. families go bankrupt annually because they can’t afford healthcare.

This is due in large part to doctors and hospitals routinely billing insurers ludicrous amounts to bump reimbursement rates higher.

List prices for healthcare, known as the “chargemaster,” generally bear no relation to actual costs. A 2016 study found that most hospital chargemaster prices are four times greater than the actual cost of providing treatment.

Why the Stop Loss Decision is Critical for Larger Self-Funded Employers
By Trion Group / Modern Restuarant Management / / Read Article

There are stories nearly every day in the media about innovations in healthcare, breakthrough treatments, and in some cases cures for various illnesses. For example, think of all the new cancer treatments like Keytruda and Opdivo that have come to market in recent years that extend life. What’s frequently omitted however, is the cost of some of these miracle cures.

Over the past five years, nearly every one of our restaurant groups has incurred at least one cancer claim of at least $300,000. We also have seen a dramatic increase in the frequency of claims exceeding $1,000,000.

What’s driving these stop loss renewal increases of million dollar claims is the specialty drug pipeline and gene therapies. This issue impacts employers in all business sectors; however, for employers in the restaurant business, making sure your risk is placed appropriately becomes even more complicated.

On a basic level, stop loss insurance provides protection against catastrophic or unpredictable losses. This means astrategic decision on stop loss coverage involves balancing the cost of guaranteed premium payments with the potential financial impact of accepting additional risk. Factors to be considered include:

The deductible level of specific stop loss coverage chosen
Whether to accept lasers that limit or exclude risk on individual high claimants
The advantages and disadvantages of no new laser contracts
Whether to purchase aggregate stop loss coverage

Let us help you champion your goals of reducing
your self-insured client's healthcare spend.
Access Our Price Comparison Calculator

This MetLife executive breaks down three must-have benefits for 2022
By Deanna Cuadra / ebn / / Read Article

Employees still want traditional benefits, like medical, disability, dental and life insurance. But what our study found is that employees need their benefits to go above and beyond. They want nontraditional benefits like pet insurance, critical illness insurance and legal insurance.

But our study shows that what employees really want is the ability to create a portfolio of benefits that will serve their particular and unique circumstances. There are a lot of different and diverse people and generations in the workforce, so benefit offerings can no longer be a one-size-fits-all. Employees want the agency to build a life that is meaningful to them.

The employers who recognize that the world is different, identify the trends and try to go that extra mile to allow their employees to have access to these other voluntary benefits will be the employers who win this war for talent that we are all waging.

Employer-Sponsored Retirement and Health Plans: What You Need to Know for Year-End
Troutman Pepper / / Read Article

While year-end is ordinarily a busy time for companies, the number of COVID-19-related pieces of legislation and developments present additional items employers and plan sponsors must address in wrapping up 2021.


While employers are tasked with a number of requirements and obligations that must be satisfied prior to year-end, employee benefit matters must not be left to slip through the cracks. As 2022 gets closer, employers should be diligent in making required amendments, keeping track of new deadlines and processes, and staying alert for updates and guidance related to the considerable amount of COVID-19-related legislation. For assistance in evaluating how to manage your year-end to-do's, please contact a member of Troutman Pepper's Employee Benefits and Executive Compensation team.

Comparing Dental Benefits Included with Medicare Advantage Plans Can Save Seniors Thousands
Jesse Slome
Expert - Director Long Term Care Insurance Association, Medicare
Yahoo Finance / / Read Article

Dental care is especially important for seniors. According to the Centers for Disease Control, one in five adults 65 or older have untreated tooth decay. Over two thirds (68%) have gum disease. Oral hygiene is an important part of keeping your overall health in shape, but standard health insurance does not include caring for your teeth and mouth in regular coverage.

Medicare does not generally cover dental care. However, Medicare Advantage plans are increasingly beginning to offer Medicare dental benefits. In 2021, some 16.6 million MA plan individual enrollees had access to some dental coverage. Roughly 24 million individuals have Medicare Advantage coverage.

How to find the right Medicare dental plan

When it comes to considering dental benefits, the first point of comparison should be which dentists are covered by a particular plan. Some require the use of dentists who are part of a designated network. Another will allow you to use any dentist you prefer. Simply pay the dentist and submit a claim for reimbursement up to the maximum. In the case of a plan from a leading national insurer, the maximum plan limit for 2022 will be $1,500.

Secure Retirement Institute: Total Annuity Sales Rise 12% in Third Quarter
Year-to-date fee-based variable annuities hit record sales levels
LIMRA  / / Read Article

Total U.S. annuity sales were $62.3 billion in the third quarter, up 12% from third quarter 2020. Year-to-date, annuity sales increased 19% to $191.4 billion, according to results from the Secure Retirement Institute® (SRI®) U.S. Individual Annuity Sales Survey.

“Interestingly, nearly half of all retail annuity sales (49%) used nonqualified assets,” said Todd Giesing, assistant vice president, director of SRI Annuity Research. “Generally, nonqualified annuity sales have held about 42% of the retail market in the past 10 years. We are seeing significant increases in nonqualified sales through all deferred annuity product lines, a key indication that tax deferral is a significant driver of growth in 2021.”

“Over the past five years, RILA sales have jumped ten-fold, driven by market conditions, new carriers entering the market and expanded distribution,” noted Giesing. “As investors continue to seek investment growth with a layer of protection, we expect this trajectory to continue. SRI projects sales to exceed forecasted expectations, with 2021 sales exceeding $36 billion.”

Now Is the Time to Boost Your Employee Benefits and Take Full Advantage of New Options

Don't put this off—many employers are expanding and adding benefits, with new options including pet insurance, prepaid legal plans and gym memberships
JEANETTE PAVINI / TheStreet / / Read Article

It’s that time of year: open enrollment. And as consumers are rethinking their medical, dental and vision plans, there are new and expanded options available that could efficiently and cost effectively address your overall financial planning needs.

I connected with Faron Daugs, CFP, founder and CEO of Harrison Wallace Financial Group to learn his best tips and considerations consumers should be aware of for their financial plans during 2022 open enrollment. We also cover other voluntary benefits that are being added by employers that are worth taking into consideration.

Biden administration buys 10 million courses of Pfizer Covid treatment pill
Spencer Kimball / CNBC / / Read Article


“My administration is making the necessary preparations now to ensure these treatments will be easily accessible and free,” President Joe Biden said in a statement.
In a clinical trial of adults age 18 and over who were more susceptible to contracting severe Covid, Paxlovid demonstrated 89% efficacy in preventing hospitalization and death when taken within three days of symptom onset, according to Pfizer.

Biden said delivery of the pills will start at the end of this year and continue through 2022.

CVS to close about 900 stores over next three years, as it shifts to digital strategy
Melissa Repko / CNBC / / Read Article


CVS Health said Thursday that it will close about 900 stores over the next three years, as it adjusts to shoppers who are buying more online.

The drugstore chain said it will focus more of its efforts on digital growth and turning its stores into health-care destinations.

‘These guys pressure you to pay for the insurance.’ Health coverage buyers plagued by misleading marketing, studies show
By Eleanor Laise / MarketWatch / / Read Article

During ACA open enrollment, consumers should be on guard for deceptive sales tactics, researchers say

A quick web search made Shazad Mohammed the target of a months-long marketing frenzy.

Back in September, the 45-year-old systems administrator in Virginia Gardens, Fla., was uninsured due to a recent job change. He typed “private health insurance” into a search engine and landed on a site that promised to help him find coverage if he entered a few basic details. Within minutes, he says, his phone started ringing. And ringing. And ringing.

The callers offered Mohammed a hodgepodge of short-term health plans and other products that don’t provide the comprehensive coverage and protections of Affordable Care Act plans. Some salespeople tried the hard sell, Mohammed says. “These guys pressure you to pay for the insurance there and then on the initial call,” he says. “It’s like ‘limited seats available. When it gets filled up, that plan is gone.’”

None of the callers, Mohammed says, told him to go to, where expanded subsidies have recently made millions of people eligible for ACA plans with zero premiums, and consumers can find coverage regardless of preexisting conditions.

GoCo Selects Vericred to Bring Groundbreaking Automation to Small Group Benefits Enrollment
Vericred’s enrollment and member management API enables GoCo to reduce new employer group setup time from weeks to days while automating key functions for benefits administrators and HR teams
BUSINESS WIRE / / Read Article

Vericred, the API platform powering digital quote-to-card experiences in health insurance and benefits, today announced that GoCo, a leading provider of flexible software solutions for HR, benefits, and payroll, has selected Vericred’s enrollment and member management API to dramatically simplify and speed up small group benefits setup, enrollment, and administration. With the API integration, GoCo can now activate new groups for their employer customers substantially faster—within days instead of weeks—without manually forging individual connections between its platform and carriers to facilitate data exchange.

Simplifying Benefits Administration

GoCo is an all-in-one HR platform that streamlines time-consuming HR tasks, including benefits administration. With the integration of Vericred’s API, GoCo is, for the first time, automating previously manual employee benefits enrollment tasks for its small business customers. The move will save employers and brokers time and resources as they add or update benefits for employees.

Photo Of the Day


Monday, 11/15/21 - - Average Family Premiums Rose 4% This Year to Top $22,000; Employers Boost Mental Health and Telemedicine amid COVID-19 Pandemic, Benchmark KFF Survey Finds

Tuesday, 11/16/21 - - Child care benefits attract and retain employees | Expert column

Wednesday, 11/17/21 - -  Focus on Well-Being Sets Small Businesses Apart to Attract & Retain Talent, According to Guardian Life Research

Thursday, 11/18/21 - -  ‘Free Multimillion-Dollar Life Insurance’ Has Some Insurers Running For The Exits

Friday, 11/12/21 - -
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