A medical procedure should have cost $100 — it was billed for $8K. Why this is a call to action for advisers
How tough can it be to get an ingrown hair treated in the U.S. healthcare system?
My husband’s recent experience serves as a harrowing cautionary tale about navigating the maddening maze that employee populations count on us to do for them.
It started with a few ingrown chest hairs that disappeared and then was followed by an ingrown abdomen hair that looked infected. A trip to our closest walk-in clinic and $115 dollars later, he left with an antibiotic script that took the pharmacy at Winn Dixie about three hours to fill at a cost of $4. The clinic suggested that he probably had MRSA, an infection caused by a type of staph bacteria that has become resistant to many antibiotics, but didn’t test for it. Read more
MEDICARE
Sponsored by AGA
It’s ‘Telehealth vs. No Care’: Doctors Say Congress Risks Leaving Patients Vulnerable
Congress’ $1.7 trillion omnibus spending package included a two-year extension of pandemic-era funding that helped telehealth services grow nationwide. But that cash bridge, embraced by those delivering services to patients in rural areas, doesn’t provide much certainty for the future of remote medicine.
When the COVID-19 pandemic hit, Dr. Corey Siegel was more prepared than most of his peers.
Half of Siegel’s patients—many with private insurance and Medicaid—were already using telehealth, logging onto appointments through phones or computers. “You get to meet their family members; you get to meet their pets,” Siegel said. “You see more into their lives than you do when they come to you.” Story continues
Medicare Recipients Face Significantly Higher Projected Costs: EBRI
An annual estimate of how much money a 65-year-old Medicare beneficiary should have in savings to cover health care costs in retirement jumped yet again in 2022, according to the Employee Benefit Research Institute.
The predicted health savings targets shot up by about $17,000 for a 65-year-old man enrolled in a Medigap plan with average premiums and median prescription drug costs, assuming the goal is to have a 50% chance of holding enough liquid assets to cover all out-of-pocket care expenditures. Continue reading
COMPLIANCE
Sponsored by Word&Brown
Health care fraud: DOJ recovered $1.7B in false claims cases in 2022
The Justice Department intervened in a case against Cigna and plans to continue to litigate other cases against Elevance Health, UnitedHealth Group and Kaiser Permanente.
The health care industry has the dubious distinction of being responsible for more than three-fourths of all False Claims Act settlements and judgments in the fiscal year that ended last September 30.
Of the more than $2.2 billion reported by the U.S. Department of Justice, more than $1.7 billion involved drug and medical device manufacturers; durable medical equipment; home health and managed-care providers; hospitals, pharmacies; hospice organizations and physicians. This total represents only recoveries from federal losses, although in many cases, the department was instrumental in recovering additional amounts for state Medicaid programs.
The department reported settling high-profile cases in several health care categories: Dig deeper
6 Great Questions To Help You Measure Annual Enrollment Success
by
With the dust settling on annual enrollment, we can all breathe a small sigh of relief. It’s time-consuming, challenging, and maybe even a bit stressful for your whole HR team. Hopefully, your benefits administrator helped simplify things. But if you had trouble, take the advice of 90s Britpop band, Oasis, and “don’t look back in anger.” Instead, look back and learn.
Find out how to improve annual enrollment, so it’s even better next year. Here are a few simple questions you and your HR team can ask. Find out more
FINANCE
Sponsored by TWH
SEC Reveals Top Exam Priorities for 2023
The Securities and Exchange Commission released Tuesday its exam priorities for 2023, with exams of advisors’ compliance with the new marketing rule and Regulation Best Interest topping the list.
The exam division said that it will focus on whether registered investment advisors have adopted and implemented written policies and procedures to prevent violations by advisors and their supervised persons of the new rule and whether RIAs have “complied
with the substantive requirements” of the rule.
Also a priority will be exams of broker-dealers’ and RIAs’ use of emerging technologies and cryptocurrencies and how these firms are “employing new practices, including technological and on-line solutions to meet the demands of compliance and marketing and to service investor accounts,” the agency explained.
Exams of registrants “will focus on the offer, sale, recommendation of, or advice regarding trading in crypto or crypto-related assets” and include whether the firm: Continue reading
EXIT PLANNING
Sponsored by Strazzeri/Mancini
Six Pack Series- a Guide for Group Health Benefit Professionals
In January we introduced succession planning for small business owners and suggested ways that group benefit brokers can consider to learn more about business succession planning and to work with a team to bring resources to their business owner clients. We wanted to offer an open invitation for group health brokers to both access online information on succession planning and join monthly calls and in person Exit Planning Institute Chapter meetings. In the Spring we will begin a formal education program to cover ways you can approach your group clients on the topic of business succession planning. This series is called our “Six Pack Series- a Guide for Group Health Benefit Professionals”. More details to come soon.
CalBroker suggests joining a free Local Exit Planning Institute (EPI) meeting or Southern California Institute meeting (SCI.) The link below leads to resources you can take action on now.
Learn from independent attorneys, CPAs, bankers, financial planners, investment advisers, insurance and real estate professionals, presenting training sessions every week.
Follow these Links to see the next upcoming meetings, (California Broker readers are welcome):
1. Weekly Thursday Insights Schedule and Registration:
www.SCInstitute.org/ThursdayInsights
2.EPI Orange County Chapter Meeting Schedule and Registration:
2nd Thursday of the month in-person ONLY
3. EPI San Diego Chapter Meeting Schedule and Registration: ‘
4. EPI Los Angeles Chapter Meeting Schedule and Registration:–
4th Wed of the month: zoom & in person
For additional information call: 858-200-1900
HOT PRODUCT FOR CALBROKER READERS:
“Special Offer to Learn Succession Planning to help your Group Health Clients”
Here is the link to the Basic Membership (normally $49/month) product on the academy: https://sciacademy.socialjack.com/product/basic-membership/
Once they open the link, they just click “add to cart” and then enter Calbroker23 in the coupon code field and complete the checkout process.
Health Brokers, Find Your Successor PLEASE!
BUSINESS CONTINUITY
By Danniel Wexler and Phil Calhoun
How do I keep and protect what I have built? How do I create value that someone would purchase? How do I sell or transfer my business when I am ready? Brokers who build a book of business need to think like any business owner and consider these questions. We found the answer: “Find your successor, please!”
We came to this conclusion when a few years back we set out to listen to broker’s questions and concerns about protecting their commissions. From the results of ongoing California Broker Magazine surveys, from our continuing education programs on succession planning, and from numerous discussions with carrier and general agency representatives, the clear and consistent planning message we hear is: brokers want control of their commissions while they are active in the business. The unfortunate fact is most brokers fall short when planning how to protect their commissions in all life events, namely death, disability and retirement.
In this article, we outline best practices to protect commissions and explain why a successor is required. We also cover how adding a purchase agreement with a commission protection plan is the ideal model for a comprehensive plan. Article continues
GROUP BENEFITS
Sponsored by United Healthcare
Employer advocacy group urges Congress to improve employee health care and retirement
The ERISA Industry Committee sent a letter to legislators, outlining their objectives to improve health care, retirement and paid leave benefits that their members provide to millions of American workers.
Individuals are not the only ones making resolutions for 2023. The ERISA Industry Committee (ERIC) spelled out its objectives in a recent letter to congressional leaders.
“We are eager to engage with you and the 118th Congress to continue advancing legislative solutions that will promote the well-being of American workers, retirees and their families,” President James Gelfand wrote. “ERIC welcomes the opportunity to discuss our policy priorities, which are focused on improving employee health and financial security; increasing flexibility and opportunity; reducing costs and administrative burdens; and helping large employers continue to deliver uniform, national benefits programs related to health care, retirement, paid leave and compensation.” Story continues
Sponsored by BenefitMall
BenefitMall has been recognized as a 2023 National Top Workplace for the 3rd year in a row.
This award celebrates nationally recognized companies that make the world a better place to work together by prioritizing a people-centered culture and giving employees a voice. The Top Workplaces USA award is based entirely on feedback from an employee engagement survey completed by the employees of participating workplaces. You can learn more here
Health plans, providers can save nearly $25B annually by automating transactions, study finds
The U.S. health care system spent $60 billion conducting nine common administrative transactions — an increase of roughly $18 billion over the previous year.
Although automated workflows implemented during the pandemic increased efficiency, staffing challenges and greater health care use contributed to overall higher year-over-year administrative spending.
“Over the past 10 years, despite a rapidly changing health care landscape, payers and providers have made dramatic gains automating transactions and reducing the cost of business processes,” says April Todd, chief policy and research officer for CAQH. “Our latest report shows that this trend toward greater efficiency continued last year, even though post-pandemic factors increased total spending.” Continue reading
INFOTECH
The Top 5 HR Trends of 2023: Leveraging Tech to Put the ‘Human’ Back in HR
By Ted Bloomberg, Chief Executive Officer of bswift and Joel Nihlean, Senior Content Development Manager at bswift
My watchword for the last few years has been “adaptability.” How we work has changed, and so has the workplace itself. But with a little forward-thinking, we can remain resilient and productive this year.
In 2023, technology will continue to play a major role in how we adapt. One of the key ways organizations can do this is by leveraging UX insights, virtual assistants and other tech to streamline and automate HR processes. The goal for 2023 is to stay true to the core of “human resources” by freeing up HR teams to focus on the human side of their work.
Here are five trends we’re watching in 2023: Story continues
INDUSTRY CALENDAR
- Feb. 22, 10:00 am – 3:00 pm PST, NAIFA San Diego Business Planning Summit. Topics include planning for business owners, business succession planning, life insurance strategies for business owners, employee stock ownership plans, exit strategies and more. Learn More & Register
- Feb. 23, 10 – 11am PST, CAHIP webinar “Traditional vs. Hybrid Long – Term Care Insurance.” Register
- Feb. 23, 11:30–1:30 pm PST by Zoom, 70th Annual Will G. Farrell Award & Leadership Recognition Event, sponsored by NAIFA-LA and FSP. Info: janet@wifs-losangeles.org
- March 4, 9:00-1:30 pm PST, by zoom: WIFS-LA Women’s Forum “Embrace Empowerment.” Info:janet@wifs-losangeles.org
CONFERENCES
- March 13-15, Ellevate Women’s Leadership 2023 Summit, JW Marriott just outside Las Vegas. Register
- April 11-14, Virtual Fourth National Medicare Advantage Summit by Global Health Care, Virtual/Online Live Video; Media Partners: Harvard Health Policy Review, Health Affairs and Inside Health Policy. Phone: (800) 503-0078. Registration@hcconferences.com, Register
- May 8-10, CAHIP Capitol Summit Sacramento Register Here
