Thursday, July 12, 2018

Reference Based Pricing

Among the strategies being deployed by benefits brokers/consultants, on behalf of employers feeling squeezed by ever increasing health insurance costs is REFERENCE – BASED PRICING (RBP).  Variances in the price of healthcare can be as much (or even more) as 500% for the same services…with little to no difference in quality.  Don’t believe me?  See forLEARN MORE

Wednesday, March 21, 2018

Medical Expense Tax Deduction UPDATE!

The Tax Cuts and Jobs Act, signed into law in late December, 2017, contained some great news for folks that incur significant medical expenses AND itemize deductions on their tax return.  Historically, the threshold used to determine the amount of eligible/deductible expenses has been 7.5% of adjusted gross income (AGI), until an increase to 10%LEARN MORE

Thursday, July 13, 2017

Stabilizing the Individual Health Ins. Market

Those of you who read my previously released – “7-Point Health Care/Insurance Reform Plan” – may recall point no. 2, which was to entice and encourage insurers to come back to the markets and resume offering affordable coverage to willing, able, and ready buyers.  (See – Several folks that read the blog outlining myLEARN MORE

Monday, June 26, 2017

My 7-Point Health Care/Insurance Reform Plan

Ordinarily, this Blog site is used to provide information, ideas, strategies, explanations; in short – clarity – for health care/insurance stakeholders.  Today I’m departing from the usual fact based format to provide my thoughts and opinions on what would be a good way forward with respect to REAL healthcare/health insurance reform. These ideas are basedLEARN MORE

Thursday, June 22, 2017


H1 – TITLE PARAGRAPH The library is populated with content on a regular basis, and currently includes a massive amount of information on such areas as The Affordable Care Act, Consumer Driven Healthcare, self funding, wellness, and relevant supreme court rulings. If you can’t find what you’re looking for using the available search engines, pleaseLEARN MORE

Monday, December 19, 2016

21st Century Cures Act Becomes Law!

On Tuesday, December 13th, 2016, the President signed into law the – “21st Century Cures Act” – which includes a provision that will be very good news to many stakeholders, in particular, employers that have fewer than 50 full time/full-time equivalent employees.  Now law, the Act addresses a variety of issues including expanded treatment for mentalLEARN MORE

Wednesday, January 20, 2016

Short Term/Temporary Health Ins.- Buyer Beware!

Short Term Major Medical (STMM) coverage, sometimes referred to as Temporary Major Medical, can be an ideal solution to a specific, health insurance related challenge.  However, changes brought upon by the Affordable Care Act (ACA) have significantly altered the rules, restrictions, and considerations relative to the purchase and reliance upon STMM coverage.  Here is anLEARN MORE

Wednesday, August 26, 2015

Long Term Care’s Silver Tsunami

Recently I read an article in a trade publication that addressed the so called “silver tsunami”, related to long term care.  While the word “tsunami” certainly got my attention, some of the statistics mentioned in the piece had me downright concerned. As an employee benefits consultant/broker, health insurance is almost always at the top of theLEARN MORE

Wednesday, July 8, 2015

Supreme Court Rulings Affecting Employee Benefits

The Supreme Court of the United States (SCOTUS) recently issued separate rulings affecting the health insurance and employee benefits sectors. The “King v. Burwell” decision assures that health insurance subsidies will continue to be provided to eligible individuals in all states, even those that don’t have a “state based health insurance exchange”. And the “Obergefell v. Hodges” ruling held that state laws (in 14 states) banning same sex marriages were unconstitutional. While the former ruling affecting ACA subsidies will primarily assure continuation of previously implemented aspects of the law, and prevent what could have been serious disruption, chaos, and premium rate impact; the later ruling will require examination of, and changes to many policies and procedures. Here’s a brief overview of the more pertinent areas deserving attention…

Wednesday, November 26, 2014

Narrow Networks…Healthcare Buyers Beware!

In the current, post Affordable Care Act (ACA) world, the term – narrow network is often heard, and at times, is a strategy deployed by employers and insurers. There are a variety of other ways to describe narrow networks, such as – carve out network; exclusive provider network; select network; tiered network…you get the idea. From a covered members standpoint, this strategy involves limiting the number of contracted providers plan members can seek care from, and in return, receive the best benefits, and lowest out of pocket costs. From the standpoint of the insurer or employer, narrow networks mitigate risk and reduce expenses.