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Risk Managers Blog 03/20/2019 10:41
$64,000 Question House Bill 3987, if passed, will direct a commission to study alternative mechanisms for offering health benefit plan coverage to the affected employees and the affected employees’ dependents. Will “alternative mechanisms” include a study of Reference Based Pricing strategies? We noticed the commission members will not include anyone from the medical community. The commission is […]
Risk Managers Blog 03/15/2019 12:04
I get emails like the one below almost every day on claims incurred under various Reference Based Pricing plans. The redacted email below shows how egregious health care billing practices are and what consumers are expected to pay in relationship to what Medicare pays. REDACTED EMAIL: Below is a provider negotiation for JANE DOE on […]
Risk Managers Blog 03/13/2019 16:08
For a low co-pay of $10 every time you order a meal and a reasonable $6 delivery charge (tips encouraged) you can get free meals from Blue Cross if you live in designated areas. You don’t even have to be a Blue Cross member, although those are the ones paying for all of this…………… Blue […]
Risk Managers Blog 03/12/2019 17:22
A major carrier (Mother) will require all new self-funded employer customers (Children) to incorporate this feature into their plan designs……………….As children don’t you hate to be told what to do? Related blog posting: Selecting a Third Party Administrator UnitedHealthcare and OptumRx will REQUIRE all new self-funded employer customers to incorporate this feature in their plan designs […]
Risk Managers Blog 03/11/2019 11:32
Reinsurance is a key pillar of Lockton’s aggressive growth plan…………………….. by Ryan Smith11 Mar 2019 Lockton has announced the formation of Lockton Global Re, a new global reinsurance business. The new venture will be led by a team including Tim Gardner, current CEO of North America operations for Guy Carpenter; Claude Yoder, current managing director and global […]
Risk Managers Blog 03/11/2019 11:27
1980’s BCBS Representative At Work I remember years ago when I was a naive young salesman for BCBS working in a rural area office. I was eventually promoted to a big city office. It was a new experience for me. I noticed real fast that all the other sales reps. were involved in some sort […]
Risk Managers Blog 03/11/2019 09:17
Does your self-funded health plan have the latest technology required for advanced risk management purposes? Deerwalk Integrates Provider Quality Ratings to Support Strategic Healthcare Planning MyHealthGuide Source: Deerwalk, Inc., 3/7/2019 BOSTON — Deerwalk, Inc., an innovative population health management, data management, and healthcare analytics software company has partnered with Quantros to integrate CareChex®, an innovative medical quality rating […]
Risk Managers Blog 03/07/2019 12:54
Direct Primary Care (DPC) centered health plans make sense. So do capitated arrangements like Dr. Mensinks’s for not only members of group health plans but otherwise uninsured members of the community. With the high cost of dependent health insurance in group insurance plans, an optional DPC plan gives members affordable access to basic health care…………….. […]
Risk Managers Blog 03/05/2019 14:24
War On Drugs Continues………. We specialize in helping self-funded employers dramatically reduce Rx spend while providing members a $0 Rx copay for many name brand and specialty meds. How do your renewal meetings go when you deliver another increase due to high cost specialty meds? What if you had a solution that monitors the drugs […]
Risk Managers Blog 03/05/2019 11:25
“No problem Joe, I’ll make a call for you” Insurance Fraud & Political Empowerment By Bill Rusteberg Texas school districts provide access to health insurance for employees and their families. State taxpayers underwrite a portion of the cost while employees and local taxpayers fund the rest. In many cases the employees bear most of the […]

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