Stop Loss Insurance… More Important Than Ever

Stop Loss Insurance... More Important Than Ever

With the increase in popularity of self-insurance, health plan sponsors must take the time to fully understand the “safety net” that is typically purchased alongside these plans to protect them from unexpected costs. There are two elements of stop loss: Individual (or Specific) Stop Loss (ISL) protects against the costs of any one claimant exceeding… [Read More]

Good News – the Stop Loss Market Is Vibrant

Good News – the Stop Loss Market Is Vibrant

Uncertainty and frustration abound in the healthcare market today, especially with all of the brewing legislative changes and tension over the market’s response. On the employer-sponsored plan side of things the challenge to improve affordability goes on as well – but you can only make so many plan design changes to keep up. High deductible… [Read More]

Donald Trump is Coming to Town

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A musical and seasonal spin on U.S. healthcare and politics as we get ready to close out 2016. Set to the tune of Bing Crosby’s “Santa Claus is Coming to Town” SHARE THIS!

Politics and Healthcare

health policy

In the shadow of the failure of federally sponsored co-op: Health Republic, New York hospitals and other providers are lobbying hard for a healthcare guaranty fund to indemnify them against failures by other insurers. A common theme in this blog (see related posts here, here and here) is that the governmental role in healthcare should… [Read More]

More Bad News for the Individual Exchanges

healthcare exchange

In what came as no surprise to the insurance world, Aetna announced it is losing money in its individual exchange business. This comes on the heels of both UnitedHealthcare and Anthem Blue Cross announcing they had lost money in this segment. As we have chronicled in the past, the exchanges are enrolling fewer people than… [Read More]

Small Groups Have Options – PEOs

Calculating Healthcare Cost

Professional Employer Organizations (PEOs) are a potent weapon for small groups facing costly premiums, limited networks, very high deductibles and plans with no out-of-network benefits. The PEO is a business which takes over the human resource and benefits function from an employer. Instead of being forced into the community rated pool, the PEO aggregates small… [Read More]

Beyond the Obvious Policy: Creating a Financial Advantage through Life Insurance

Fun Facts about the Public Healthcare Exchanges

This month is the 12th anniversary of the industry advocacy campaign known as Life Insurance Awareness Month. There are plenty of good reasons to have a life insurance policy in place – and many employers and employees likely already know, and understand, these. But while many recognize the value of life insurance, I’ve seen many… [Read More]

Preventive Service – Or Is It?

Preventive-Service-–-Or-Is-It

Most health insurance plans these days cover “preventive services” at 100% with no member liability. However, as a result of recent changes due to the ACA, there are some unexpected and unwelcomed billing surprises in store: tests and services that used to be covered as preventive may no longer be considered preventive by your insurance… [Read More]

Three Reasons King v. Burwell Matters to Employers

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Last week, the media was saturated with coverage of the latest Affordable Care Act lawsuit which challenged the legality of offering subsidies on the federal exchange for those states that failed to erect their own. As the plaintiffs in King v. Burwell argued, extending subsidies on the federal exchange appears to conflict with the text… [Read More]