Hospitals, Part 1

10:14 pm in General by The Broker

My mother was recently in the hospital. You know this from my last not-a-post. I’m going to tell you about what happened.

For the last few years, my parents have been forced to play with fire. They lost their health insurance when my father’s company laid him off. It wasn’t until recently that they qualified for certain state insurance and began seeing doctors again. My dad faced his own terrible diagnosis. That is a story for another time. My mother realized her diabetes was back with a vengeance.

Machines Can Be A Boon As Well As A Bane

4:12 pm in General by The Broker

Machines Can Be A Boon As Well As A Bane

Life is a lot easier now thanks to the various electrical appliances and gadgets that have been invented. Gone are the days of drudgery when all the housework had to be done manually. House cleaning, washing of clothes, washing dishes; all these tasks had to be done with no other help. During the time when refrigerators were not even invented, food had to be cooked fresh—there was no question of cooking and freezing. Today there is an appliance for every task. Most people have washing machines, vacuum cleaners; refrigerators, dish washers and televisions, and these are not considered luxuries but rather necessities. The problem arises when any one of these machines becomes faulty. Not only will the cost of repairing be very high, but the inconvenience caused is also to be taken note of. To protect yourself from such an occurrence it is better to take up a cover, like a fridge freezer insurance. This will take care of all unexpected charges.

Four Traits of Peak-Performance Producers

10:12 am in General by The Broker

"Businessman With Chart" by AmbroA participant in a Beyond Insurance workshop recently asked, “What are the best practice characteristics of a successful producer?  Do I have the skillset to become a peak-performance producer?”

In 1961, the insurance industry hired Herbert M. Greenberg, Ph.D., to learn “what makes a good salesperson.”  Dr. Greenberg discovered that effective producers have three key traits, which remain valid today:  empathy, ego drive, and ego strength.

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Good News, But I’m Still Grouchy

4:15 am in General by The Broker

happy-cat-1024

Good news first. I got a call first thing this morning that my ultrasound was completely normal. I shed a few tears on my way to teach my class, and then I found myself in a complete exhaustion for the rest of the day. I don’t know whether it’s that I worked myself up too much yesterday, or it’s the cold and rainy weather getting the best of me.

Randy Ricks’s New Business!

10:12 pm in General by The Broker

I am excited to announce the creation of “Ricks Insurance.” After fifteen years as a “captive agent” and many awards and successes, I have joined LTCPG as an Independent Broker. This allows my clients to get the very best value for their insurance dollar, as I can search essentially every carrier and every product to meet their exact custom needs.

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Self Funding 101

4:13 pm in General by The Broker

Self Funding 101
Self funding of medical insurance has always been the domain of larger employer groups. At certain times in the not so distant past, the minimum size for self funding has been as many as 250 employees on the plan. More recently, these minimum numbers have decreased to 100 lives then down to 50 lives…at a certain point, it became a matter of being able to engage a reinsurance carrier that determined what size group would qualify to self fund their medical plan.
Maybe at this point, it might help to give a little background. Self funding group medical benefits are governed under ERISA (Employee Retirement Income Security Act of 1974). This causes these plans to be governed on a Federal Govt’ level rather than state by state, like most insurance vehicles. This allows plan sponsors to opt out of certain state mandated benefits. Also because most of the cost of self funding is not an insurance product, premium taxes are greatly reduced also. This along with the obvious advantage of saving money if claims are lower than expected gives self funding its appeal to the right employer group.
Other advantages of self funding are the ability to receive claims reports in time to respond to any trends, a focus on health and wellness, flexibility in plan design. The employer essentially owns their own plan and has more control.
Traditionally groups have purchased reinsurance in two ways; on a specific or per insured basis and on an aggregate basis or a deductible for the entire group. These monthly costs for the insurance along with the cost of administering the plan make up what is called the “fixed costs.” A TPA (Third Party Administrator) is usually hired to pay claims and monitor regulatory issues for the employer.
These are costs that will be incurred on a monthly basis regardless of what claims are incurred. Under the traditional self funding model the claims are simply paid when incurred out of the employer’s general fund (sometimes the employer will set up a zero balance checking account for accounting purposes.)
As you can see from the above example, the month over month claim activity is not very predictable and requires an employer with the ability to bear fluctuating claims costs. One of the major changes that has been designed into the partially self funded plans for smaller employer groups is the monthly accommodation. By using this employers pay the maximum costs for the plan on monthly basis and if claims exceed the amount set aside to pay claims in any given month, the insurance company advances that amount of money and allows future premium payments to “pay back” the amount advanced. Essentially this is an interest free loan from the insurance carrier. This along with maximum or level funding gives the small employer all the advantages of self funding with none of the risk.
With the risk engineered out of self funding smaller employers can now have the same advantages when it comes to healthcare as their larger counterparts have always enjoyed.
Self funding may not be for every employer, large or small. Careful consideration and the right broker to advise of all the options is essential when making these decisions.

Herniated disc

10:13 am in General by The Broker

So last week I go to the dr. My neck and shoulder area have been bothering me for the past month and with nothing working I go to the dr. We take some X-rays and the the dr who happens to be an orthopedic dr says I believe you have a herniated disc in your neck. We need to get you am MRI to determine how bad it is. In the mean time keep taking your aleeve for the pain and inflammation. SMH😳😳😳😳😳😡😡😡😡😡

Clinical Advisor Weighs In on DPC in Marketplace

4:12 am in General by The Broker

Can ‘concierge medicine’ improve primary care?

SEPTEMBER 11, 2014

the Clinical Advisor take:

Too many patients, too few providers, and too much paperwork have fractured primary care in the United States, according to an article published in Medical Economics. Shifting traditional primary-care practices to direct primary care models may solve the ‘primary-care crisis’.

“The crisis means that there are not enough primary-care [providers] today, and it will only get worse because students in medical school see the impact of the crisis and choose not to enter primary care as a result,” explained author Stephen C. Schimpff, MD, former CEO of the University of Maryland Medical Center.

How is Cyber Liability Insurance Part of Compliance?

10:14 pm in General by The Broker

Ester Horowitz, https://healthcareincompliance.wordpress.com, discusses technology compliance and privacy in the medical field. The federal government has a team – I call them the “HIPAA police” – auditing medical organizations of all kinds and sizes to ensure they are following privacy rules, and some are receiving large fines because of non-compliance. The HIPAA police are looking at two specific areas:

  • Written documentation showing the infrastructure is in place; and
  • Proof that organizations are practicing what they wrote.

These audits are also looking at Cyber Liability and the potential for breaches of privacy associated with electronic health records/practice management systems. With mobile technology, the risk of exposure has only increased. Statistically, the main sources of exposure to identity theft are lost laptops and personal devices.

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IS Offline Insurance Better Than Online Insurance

4:12 pm in General by The Broker

A survey shows that if we purchase any insurance plan online is not cheaper than we purchase it manually from the insurance provider company. Recently I find this news on the internet, but we cannot avoid the benefits of purchasing the coverage policy from the insurance provider’s website. According to that survey, if we purchase a coverage plan via the adviser (agent) or the company, it costs lower than we purchase the same protection plan online. But on the other hand, if we take help of assurance provider’s website, we can compare the plans provided by the insurer and it definitely helps us to buy an affordable assurance policy for our protection. It is true that if we purchase the coverage plan directly from the company or insurance agent, we cannot compare the plan with other insurer easily it means we have to compare it manually. On the other side, if we purchase coverage plan from the insurance carrier website, we can get online assurance quotes and check out their different plans from the home. We can also check out their terms and conditions provided by the insurers. May be the survey is right, but if we consider the benefits and comfort than I think online insurance is better than we buy protection plan manually from the company.

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