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Trump administration proposes Obamacare changes

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President Donald Trump has stated again and again a major goal: Repeal and replace the Patient Protection and Affordable Care Act, also known as Obamacare. A repeal – or replacement – hasn’t happened yet, but on Wednesday, the Trump administration submitted a proposal that it claims will stabilize the ACA health insurance markets. A move to stabilize the ACA may seem at odds with the goal of replacing it, but in the absence of a replacement, the proposal is a first step toward Obamacare in… Reported by bizjournals 3 hours ago.

While Congress struggles to replace Obamacare, the Trump administration is moving to reshape health insurance on its own

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With congressional Republicans struggling to develop an Obamacare alternative, the Trump administration is taking steps on its own to loosen government regulation of the nation’s health insurance markets, a longtime conservative goal.

Administration officials said the moves — which were detailed... Reported by L.A. Times 4 hours ago.

Aetna CEO Says Obamacare In "Death Spiral" And "It's Getting Worse"

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Aetna CEO Says Obamacare In Death Spiral And It's Getting Worse Back in the summer of 2016, as Obamacare rates were being set for the 2017 plan year, we repeatedly argued that the entire system was on the "verge of collapse" as premiums were soaring, risk pools were deteriorating and insurers were pulling out of exchanges all around the country leaving many Americans with just a single 'option' for health insurance (see "Obamacare On "Verge Of Collapse" As Premiums Set To Soar Again In 2017").

And while Democrats may be all too willing to quickly dismiss our analysis, they may want to listen to the warnings of the CEO of one of the country's largest health insurers who says that Obamacare is in a *"death spiral."*  In speaking with the Wall Street Journal, Aetna CEO Mark Bertolini said, among other things, that the "*risk pools are deteriorating in the ACA"* to a point that it would inevitably result in more withdrawals this year.   Per The Hill:



*"It's not going to get any better; it's getting worse."*

 

"That logic shows just how much the* risk pools are deteriorating in the ACA*," Bertolini said.

 

He added: *"I think you will see a lot more withdrawals this year*. ... *There isn't enough money in the ACA as structured, even with the fees and taxes, to support the population that needs to be served*."

 

*"It is in a death spiral,*" he said, but did not say whether Aetna would participate in the exchanges in 2018.



 

And, while his commentary was mostly doom and gloom, if there was one silver lining from Bertolini's interview, it was his acknowledgement that at least *"mathematics education in the United States is working"* since consumers seem to be able to run the simple math required to figure out that paying ~$12,000 per year in premiums for a family of 4, plus $6,000 in deductibles, all for a service they never use, is a bad deal.



*"You know that mathematics education in the United States is working when someone says, let me see, i'm going to pay this much premium, i've got a $6,000 deductible, and when I go to the doctor i'm going to pay cash...so premium, plus deductible, plus paying cash...why do I do this?  I'll just pay the penalty and move on."*

 

"And so that risk keeps leaving and risk inside the pool keeps getting worse...the rates continue to chase it...and the participants start to leave, either at the bottom of the risk pool or the plans themselves."



Of course, Bertolini's comments today followed yesterday's announcement from Humana that, due to an "*unbalanced risk pool"* (i.e. not enough healthy, young people paying massive premiums to balance out the risk of older, sicker customers), they would be pulling out of all Obamacare exchanges nationwide in 2018.  Per Humana's press release:



Regarding the company’s individual commercial medical coverage (Individual Commercial), substantially all of which is offered on-exchange through the federal Marketplaces, *Humana has worked over the past several years to address market and programmatic challenges in order to keep coverage options available wherever it could offer a viable product.* This has included pursuing business changes, such as modifying networks, restructuring product offerings, reducing the company’s geographic footprint and increasing premiums.

 

All of these actions were taken with the expectation that the company’s Individual Commercial business would stabilize to the point where the company could continue to participate in the program.* However, based on its initial analysis of data associated with the company’s healthcare exchange membership following the 2017 open enrollment period, Humana is seeing further signs of an unbalanced risk pool.* Therefore, the *company has decided that it cannot continue to offer this coverage for 2018.* Through the remainder of 2017, Humana remains committed to serving its current members across 11 states where it offers Individual Commercial products. And, as it has done in the past, Humana will work closely with its state partners as it navigates this process.



Meanwhile, Trump seized on the announcement saying that as "Obamacare continues to fail" his administration would "repeal, replace & save healthcare for ALL Americans."



Obamacare continues to fail. Humana to pull out in 2018. Will repeal, replace & save healthcare for ALL Americans. https://t.co/glWEQ0lNR4

— Donald J. Trump (@realDonaldTrump) February 14, 2017



 

Frankly, we're shocked at all of this! * Turns out that whole "adverse selection bias" was a real thing...who could have known?** * Reported by Zero Hedge 2 hours ago.

The One Obamacare Provision That Could Blow Up A Republican Repeal

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WASHINGTON ― As Republicans stake out positions on what an Obamacare repeal needs to look like to secure their vote, one popular component of the 2010 health care law is threatening to sink the GOP’s entire repeal effort: the Medicaid expansion.

House conservatives are adamant that any repeal bill take away the expansion, which increased free or low-cost Medicaid coverage for people making less than 133 percent of the federal poverty level ― about $16,000 a year for a single person. The House Freedom Caucus voted Monday night to oppose any repeal bill that was not as aggressive as the one the House and Senate passed in 2015. That bill gutted the Medicaid expansion.

But now that lawmakers are “playing with live rounds this time,” in the words of Rep. Charlie Dent (R-Pa.), some Republicans are showing reluctance to actually get rid of a program that has won over a number of Republican governors and covers more than 14 million people.

“That genie is out of the bottle,” Dent said of the Medicaid expansion. “And I guess I would say to you too that we have to be careful that we don’t go pulling the rug out from under people.”

Dent told The Huffington Post on Wednesday that he didn’t know if there were 218 votes in the House for a repeal bill that gets rid of the Medicaid expansion, and he said most Republicans in his roughly 50-member moderate Tuesday Group, of which Dent is the chairman, believe that an Obamacare repeal would need to be coupled simultaneously with a replacement bill and that Republicans would have to think carefully about what they do for Medicaid.

“A lot of Republicans who represent expansion states are going to handle this Medicaid issue very delicately, and they’re not going to be taking an ideological doctrinaire position,” Dent said.

If Republicans really do vote their district, that could be a problem for GOP leaders.

There are number of states that greatly benefit from the expansion ― states that voted for President Donald Trump and have heavy Republican representation in Congress, including Kentucky, Arkansas and West Virginia. The key for GOP leaders is to convince governors that gutting the expansion is in their interest, even when the federal government is paying at least 90 percent of the costs to cover their residents.

“We’re going to be listening to the governor and the Kentucky general assembly,” freshman Rep. James Comer (R-Ky.) said Wednesday. Kentucky’s uninsured rate fell by more than 12 percentage points under the Affordable Care Act ― the largest drop of any state in the nation. The state’s Republican governor, Matt Bevin, ran as an opponent of Obamacare. But after he was elected, he went back on a promise to gut the Medicaid expansion.

But don’t necessarily count on the Republicans whose districts make out on the deal to preserve it. “The Medicaid expansion is not sustainable,” Comer said. Nearly 10 percent of the people in his district are covered by the program.

The dynamic in Congress is that conservatives are intent on removing the expansion, and moderates are somewhat determined to keep it ― or at least some form of it. Leaders have to either roll one side of the conference or somehow split the difference. Either way, finding 218 votes in the House ― and, perhaps even more challenging, 50 votes in the Senate ― might not be possible with the different demands that Republicans have on Obamacare.

Asked how leaders could fulfill the Freedom Caucus requirement of removing the Medicaid expansion and still please moderates who want to preserve it, Rep. Greg Walden (R-Ore.), the chairman of the House committee with jurisdiction over Medicaid, told HuffPost on Wednesday that he thought Republicans would be able to write a bill that accomplishes more than the 2015 repeal bill and would “actually get to entitlement reform of Medicaid.”

But would Republicans be preserving the Medicaid expansion?

“You’ll see it when we roll it out,” Walden said, “but the long and short of it is we have a great opportunity to reform Medicaid, a positive way to give flexibility to states, to bend the cost curve down.”

If that sounds like Republicans are going to cut the expansion, it probably should.

The “Better Way” agenda that House Republicans put forth would end the expansion and either block-grant Medicaid or dish out money on a per capita basis. That would almost certainly please conservatives, but it would also test the resolve of moderates who want to preserve the program.

It’s just that the moderates have so far taken a softer line on what they need to support an Obamacare repeal.

House Appropriations Chairman Rodney Frelinghuysen (R-N.J.) noted on Wednesday that his state has benefited from the expansion, and he said he would have to look carefully at the repeal bill and what it does to Medicaid before committing his vote. “Obviously there has to be some sort of resolution,” he said. But that didn’t necessarily mean he would vote against something that repeals the expansion.

Rep. Peter Roskam (R-Ill.) noted he was “getting a lot of feedback” from his district on Obamacare ― protesters have zeroed in on Roskam as a vulnerable Republican ― and that he was listening carefully and looking to make a “smooth transition from the status quo to a new approach.”

Again, even in a district that went for Democratic presidential nominee Hillary Clinton, Roskam isn’t vowing to protect low-income people who are now getting health insurance free or at a very small cost. Even the moderates who are taking a more aggressive tack are putting their trust in leaders to eventually come up with something that doesn’t devastate their constituents. 

”I am confident that leadership recognizes there has to be some acknowledgment of the states that expanded Medicaid,” said Rep. Leonard Lance (R-N.J.), one of the most likely candidates to vote against the GOP’s repeal plan.

And for every Leonard Lance, there are 10 House Republicans who are dedicated to repeal no matter what. As Rep. John Shimkus (R-Ill.) said Wednesday, “If it’s a repeal, I’m there.”

The Medicaid expansion problem is trickiest in the Senate, where leadership can stand to lose only two votes and still pass a reconciliation bill repealing Obamacare, assuming every Democrat votes against it.

Sen. Mike Rounds (R-S.D.) told reporters on Wednesday that he saw problems in reaching a majority in the Senate if Republicans repealed the Medicaid expansion. 

“The problem is you also have to have all of the Republican governors supporting whatever you do or you’re not going to get the support of 51 folks stepping in,” Rounds said. “Realize we need 51 votes on this, and if you don’t treat your states appropriately, you’re probably not going to get your 51 votes.”

And if a repeal vote looks dead in the Senate, it would certainly scare Republicans in the House.

The whole repeal-and-replace gambit relies on getting Republicans with competing interests on board, even if it’s not in their constituents’ interests, with the distant promise that leaders can come up with something better. The emerging line from Republicans is that people who currently get nearly free health care under the Medicaid expansion will like having more options for insurance. 

But those people will also be paying exorbitantly more for that coverage, and there’s hardly any way for Republicans to mask that.

If moderates have ever had a chance to shape the Obamacare discussion, this is the moment. Which is why conservatives have so forcefully signaled that they won’t support any repeal bill preserving the Medicaid expansion. Their goal is to close off the possibility that a repeal bill keeping those Medicaid provisions could ever pass, leaving a measure that blows up the expansion as the only option for leaders.

The question is why GOP moderates are so timid about signaling they won’t go along with a bill that guts the program. Dent is posturing that there are vote problems if Republicans repeal the expansion, but at this point, it’s just posturing.

If moderates got serious about opposing a bill touching the Medicaid program, and if conservatives were truly serious about opposing a bill that doesn’t touch it, an Obamacare repeal might be impossible.

Asked if the repeal would be in danger if Dent really had a majority of the Tuesday Group committed to preserving the Medicaid expansion, House Freedom Caucus Chairman Mark Meadows (R-N.C.) told HuffPost that it would indeed be a problem.

“If he has more than 25 votes that are that way, yes, it’s trouble.”

Huffington Post reporter Jeffrey Young contributed to this report.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 37 minutes ago.

NN Group reports 4Q16 and 2016 results

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*4Q16 operating result up 13%; Solvency II ratio at 241%*

· 4Q16 operating result ongoing business of EUR 282 million, up 12.6% from 4Q15, reflecting a higher investment margin at Netherlands Life, higher fees and premium-based revenues at Insurance Europe and improved results at NN Bank and the reinsurance business, partly offset by unfavourable claims experience at Netherlands Non-life
· Full-year 2016 operating result decreased to EUR 1,227 million from EUR 1,435 million in 2015 which benefited from higher private equity dividends and a significantly higher technical margin in Netherlands Life, while 2016 was impacted by severe storms at Netherlands Non-life
· Net result of EUR 148 million, down 58.9% from 4Q15 mainly due to lower non-operating items and negative results on divestments. Full-year 2016 net result down to EUR 1,189 million from EUR 1,565 million in 2015
· Further costs savings in the Netherlands bringing the expense base down to EUR 761 million
· Robust commercial momentum in the quarter, with APE up 12.0% at constant currencies in the insurance businesses, net third party inflows of EUR 1 billion at Asset Management and mortgage production of EUR 0.9 billion at NN Bank. Full year VNB of EUR 214 million, up 6.4% from 2015
· Strong capital position: Solvency II ratio increased from 236% to 241% at the end of 4Q16, reflecting market impacts, the reversal of the EUR 333 million suspended share buyback and the deduction of the proposed final 2016 dividend of EUR 307 million
· Holding company cash capital higher at EUR 2,489 million, driven by dividends received from subsidiaries, partly offset by capital injections and share buybacks
· Final 2016 dividend proposal of EUR 0.95 per ordinary share, or approximately EUR 307 million in total, bringing the full-year 2016 dividend to EUR 1.55 per ordinary share

*Statement of Lard Friese, CEO*

'2016 was an eventful and important year for NN Group, a year in which we made considerable steps. We invested in accelerating change and innovating our customer experience, and worked on new and improved products and services. In April, ING completed its divestment of NN Group. We were able to maintain a strong capital position, making us well-positioned to weather volatile markets. This strong financial position allowed us to take an important step in bringing consolidation to the Dutch insurance and asset management markets and to announce an intended offer for the outstanding shares of Delta Lloyd in October 2016. After a period of constructive interactions, on 23 December we announced that the Boards of NN Group and Delta Lloyd reached an agreement on a recommended public offer with the aim to combine Delta Lloyd with the Dutch and Belgian activities of NN Group. Early February we launched the offer for all issued and outstanding ordinary shares in Delta Lloyd at EUR 5.40 per share and announced that we increased our stake in Delta Lloyd to 8.0% of ordinary shares. This transaction represents a significant step in our journey to build a profitable business for the future, and to strengthen our leading position in the Netherlands and Belgium.

NN Group reported a healthy operating result in the fourth quarter of 2016. Most of our businesses are making steady progress in delivering on their strategic targets. The Netherlands units achieved a further reduction in their cost base, which is targeted to be reduced to EUR 685 million by the end of 2018, ahead of the reduction that was expected to be achieved in 2016. Our European and Japanese insurance businesses reported higher sales as a result of the successful launch of new products, while the total value of new business increased for the full year, despite lower interest rates. NN Bank continues to generate considerable growth in the mortgage and savings markets and our asset manager, NN Investment Partners, again attracted net inflows of third-party assets in the fourth quarter. There is still more work to do, for example in bringing down the combined ratio of our Non-life business.

Our Solvency II and cash capital positions remain robust, at 241% and EUR 2,489 million respectively. We will propose a final 2016 dividend of EUR 0.95 per ordinary share at our Annual General Meeting of Shareholders on 1 June 2017. Together with the interim dividend paid in September 2016, this represents a pay-out ratio of around 51% of the 2016 full-year net operating result of the ongoing business. In January 2017, we successfully refinanced part of our outstanding debt and allowing us to repay the final tranche of hybrid debt to ING.

Looking ahead, ongoing uncertainty with regard to economic growth, macro developments, and potential political shifts are likely to impact the financial markets in 2017. Irrespective of these developments, we are committed to delivering an excellent customer service, innovating our products and further improving our businesses. The progress we made in these areas in 2016 is reflected in our employee engagement and Net Promotor Scores. This strong foundation enables us to further shape our ambition of creating a company that truly matters in the lives of our stakeholders.'

*NN Group key figures*

In EUR million *4Q16* 4Q15 Change FY16 FY15 Change
             
Operating result ongoing business 282 250 12.6% 1,227 1,435 -14.5%
Net result 148 360 -58.9% 1,189 1,565 -24.0%
Net operating ROE 7.2% 7.5%   8.1% 10.8%  
Solvency II ratio ^1) 241% 239%   241% 239%  

Note: All footnotes are included on page 28

*Quarterly Business Update*

NN Group's robust financial position in 2016 reflects the resilience of its businesses in an environment which continues to be characterised by low interest rates and market volatility. This provides a solid foundation for executing the company's strategy, which is to deliver an excellent customer experience based on transparent products and services and long-term relationships. NN Group aims to help people secure their financial futures, and is committed to delivering products and services that are easy to understand and meet customers' lifetime needs.

*Transparent products and services*

In the Dutch pension market, NN maintained its leading position in 2016. This was acknowledged by the Dutch magazine Management Team, which ranked Nationale-Nederlanden as the best pension provider in the Netherlands for the third year in a row. Moreover, the Dutch pension business introduced new features to further improve its product proposition, for example the 'additional savings' option for its Defined Contribution product which allows customers to increase their individual savings to secure future income. In Poland, the cooperation with Notus started and the Polish flagship product, a protection and investment proposition, was tailored for customers of Notus and launched in the fourth quarter.

*Capturing growth*

The fundamental need of people to protect themselves against uncertainties will continue to drive growth in the insurance industry over the long-term. NN Group adapts its businesses to capture this growth potential. In the fourth quarter of 2016, the sale of protection products grew 11% across Europe compared with the same quarter in 2015, with Romania, Turkey and Belgium as the largest contributors. In Turkey, a new law entered into force on 1 January 2017, under which all employees under the age of 45 will be enrolled in a new compulsory pension scheme while their employers can select a pension company. NN Hayat ve Emeklilik successfully introduced a new pension product to meet this new demand.

In the fourth quarter of 2016, total sales at Japan Life increased by 23%, excluding currency effects, driven by the sales of the COLI critical illness product launched in July. Bancassurance sales grew 37%, at constant currency, compared to the same quarter of 2015. This was driven by higher bank activation and the expansion of the bank distribution network, bringing the total to 61 banking partners at the end of 2016.

At the beginning of 2016, NN Romania launched the first health insurance on the local market. At the end of December 2016, over 10,000 clients contracted health insurance from NN, 50% more than initially expected for the first year.

In the Netherlands, NN Bank grew its mortgage portfolio by EUR 2.2 billion to EUR 12.7 billion in 2016. During that same period its customer savings grew by the same amount to EUR 10.2 billion. In the Dutch market, bank savings are increasingly replacing Life annuities, and NN Bank has established a strong position in this market. Movir, which offers individual disability insurance to self-employed workers in the Netherlands, successfully launched a campaign to inform medical specialists about their renewed product offering, which complements the existing disability insurance (AOV).

The fourth quarter also saw positive developments in the area of securing new contracts as NN Investment Partners was selected to become the fiduciary manager of assets under administration (AuA) for two large Dutch pension funds for a total amount of EUR 4.8 billion. In addition to this, NN Group's general pension fund 'De Nationale APF', secured its first client.

*Multi-access distribution*

NN Group serves its customers through multiple channels, comprising tied agents, bancassurance partners, brokers and direct channels. It is our aim to achieve profitable growth through multi-access distribution. In line with this strategy, our insurance company in the Czech Republic entered into a strategic partnership with Moneta Money Bank. This enables NN Czech to reach a larger number of customers and provide products to meet their protection and pension savings needs. Moneta Bank extended its product offering with NN's term life insurance and pension savings products.

In the Netherlands, the website NN.nl continues to attract an increasing number of visitors, and over 90% of NN Bank's new customer savings is generated through this online channel.

*Effective and efficient operations*

NN Group aims to make its processes as efficient and effective as possible. The businesses in the Netherlands continue to implement efficiency initiatives. For example, the pension business in the Netherlands established a system which links to salary package software from HR benefits companies, improving administrative efficiency for both customers and NN Life. In addition, NN Life entered into a strategic partnership to outsource business processes and IT for the individual life closed book. Furthermore, in line with the retail strategy in the Netherlands, several new products were made available on the online distribution channel 'My NN' and in the NN app. Also the Dutch Non-life business remains focused on increasing efficiency, for example by sending close to a million documents to the digital mailbox of intermediaries, instead of in hardcopy. Moreover, NN Bank extended digital tooling and self-service processes, providing customers with insight and options to make adjustments to their products. One example is a track and trace system for mortgage applications.

Japan Life is introducing self-compliance and medical self-service tools improving our service and reducing administrative efforts. In Belgium, a Home & Family portal was created, where customers are able to modify their Building, Contents, Theft and Family insurance, request certificates or file a claim online. This reduces manual work and delivery time and increases the self-reliance of the customer. After the introduction of tablets for our sales force in Poland in the third quarter of 2016, 90% of the new business applications were fully automated, resulting in efficiency gains and improving customers' experiences and communications.

*Innovation*

As part of our ambition to enhance the quality of advice and service to customers, improve staff productivity, and create cross-sell, upsell and retention opportunities, NN Life Japan launched a one-stop intuitive service platform for agents in December 2016, which will help strengthen relationships with distributors. Furthermore, NN's broker in Turkey, Sigorta Cini, is operating from 25 'insurance shops' across the country, and is the second most visited online aggregator in Turkey with more than 1 million unique visits annually. Improvements in website functionality and investments in search marketing has helped NN in Turkey to reach out to more online customers looking for price comparison.

The Non-life business in the Netherlands launched several initiatives to increase safety for retail and SME customers. In November, Sparklab (the innovation lab of NN Non-life) launched the Dutch Cyber Collective. This association is supporting SMEs to reduce cybercrime. Other examples include a safety check for children's bikes in schoolyards in The Hague and the 'Safest Street of the Netherlands' ('Veiligste straat van Nederland').

*Other events*

In 2016, NN launched a new campaign 'It's different when it's yours', celebrating the uniqueness of our individual customers. In the coming months, the new campaign will be launched in many NN countries. It focuses on those moments in life we all experience, yet we all experience differently. NN is proud to help millions of individuals, families, homes and businesses every day, and we are well aware that the family, home or business of each individual customer matters most to him or her.

As part of our commitment to considering environmental, social and governance aspects in our investment decisions, during 2016 experts from NN and NN Investment Partners contributed to a report called 'Building Highways to SDG Investing'. With this report, a group of 17 financial institutions including NN Group, invited the Dutch government and Central Bank to continue to make a concerted effort in cooperation with the financial sector in support of the Sustainable Development Goals (SDGs). Adopted by the United Nations, these goals relate to climate, poverty, health care, education, and other societal challenges.

*NN Group Profile*

NN Group is an international insurance and asset management company, active in more than 18 countries, with a strong presence in a number of European countries and Japan. With around 11,500 employees the group offers retirement services, insurance, investments and banking to more than 15 million customers. NN Group includes Nationale-Nederlanden, NN and NN Investment Partners. NN Group is listed on Euronext Amsterdam (NN).

*Investor conference call and webcast*

Lard Friese and Delfin Rueda will host an analyst and investor conference call to discuss the 4Q16 results at 09.30 am CET on Thursday 16 February 2017. Members of the investment community can join the conference call at +31 20 531 5865 (NL), +44 203 365 3210 (UK), +1 866 349 6093 (US) or follow the webcast on www.nn-group.com .

*Press lunch*

Lard Friese and Delfin Rueda will host a press lunch to discuss the 4Q16 results, which will be held at 11.30 am CET on Thursday 16 February 2017.

*Financial calendar*

· Publication 1Q17 results: 18 May 2017
· Annual General Meeting: 1 June 2017

  · Publication 2Q17 results: 17 August 2017
· Publication 3Q17 results: 16 November 2017

*Contact information*

*Press enquiries*

Saskia Kranendonk
+31 62 568 3835
saskia.kranendonk@nn-group.com   *Investor enquiries*

Investor Relations
+31 88 663 5464
investor.relations@nn-group.com

*Additional information on www.nn-group.com*

· NN Group 4Q16 Financial Supplement, NN Group 4Q16 Analyst Presentation
· Photos of NN Group executives, buildings and events are available for download at Flickr

*Important legal information*

NN Group's  Consolidated Annual Accounts are prepared in accordance with International Financial Reporting Standards as adopted by the European Union ("IFRS-EU") and with Part 9 of Book 2 on the Dutch Civil Code.

In preparing the financial information in this document, the same accounting principles are applied as in the NN Group N.V. condensed consolidated interim accounts for the period ended 30 September 2016. The Annual Accounts for 2016 are in progress and may be subject to adjustments from subsequent events.

All figures in this document are unaudited. Small differences are possible in the tables due to rounding. Certain of the statements contained herein are not historical facts, including, without limitation, certain statements made of future expectations and other forward-looking statements that are based on management's current views and assumptions and involve known and unknown risks and uncertainties that could cause actual results, performance or events to differ materially from those expressed or implied in such statements. Actual results, performance or events may differ materially from those in such statements due to, without limitation: (1) changes in general economic conditions, in particular economic conditions in NN Group's core markets, (2) changes in performance of financial markets, including developing markets, (3) consequences of a potential (partial) break-up of the euro, (4) changes in the availability of, and costs associated with, sources of liquidity as well as conditions in the credit markets generally, (5) the frequency and severity of insured loss events, (6) changes affecting mortality and morbidity levels and trends, (7) changes affecting persistency levels, (8) changes affecting interest rate levels, (9) changes affecting currency exchange rates, (10) changes in investor, customer and policyholder behaviour, (11) changes in general competitive factors, (12) changes in laws and regulations, (13) changes in the policies of governments and/or regulatory authorities, (14) conclusions with regard to accounting assumptions and methodologies, (15) changes in ownership that could affect the future availability to us of net operating loss, net capital and built-in loss carry forwards, (16) changes in credit and financial strength ratings, (17) NN Group's ability to achieve projected operational synergies and (18) the other risks and uncertainties detailed in the Risk Factors section contained in recent public disclosures made by NN Group.

Any forward-looking statements made by or on behalf of NN Group speak only as of the date they are made, and, NN Group assumes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information or for any other reason. This document does not constitute an offer to sell, or a solicitation of an offer to buy, any securities.

NN_Group_Press_Release_4Q16
--------------------This announcement is distributed by NASDAQ OMX Corporate Solutions on behalf of NASDAQ OMX Corporate Solutions clients.

The issuer of this announcement warrants that they are solely responsible for the content, accuracy and originality of the information contained therein.

Source: NN Group NV via GlobeNewswire

HUG#2079248 Reported by GlobeNewswire 19 hours ago.

When Speech Privacy is Vital, Acoustiblok® has the Answer

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A practicing psychologist in Toronto concerned about patient confidentiality engaged Pro-Tech Solutions to soundproof the business office. After a thorough assessment of the acoustic conditions and the structure, Acoustiblok material was installed and successfully took care of the problem.

Tampa, FL (PRWEB) February 16, 2017

Patients expect medical records to be kept private, but what about physician consultations? Typical office building and construction does not include soundproofing as a general rule. It is not uncommon when patients are waiting to see a healthcare professional in the exam room or office to overhear another patient talking in the next room with the doctor. Where this can be a bit embarrassing if a patient runs into another patient in the waiting room or hall, it can be a more serious issue if a patient is discussing confidential issues that need to be kept private and is overheard in the next room by patients or staff.

A psychologist or psychiatrist office is certainly somewhere a patient would not want conversations overheard by someone outside the door or in one of the adjoining offices. Soundproofing should be considered essential in these types of offices. This is of particular concern for psychotherapists and mental health professionals in the United States according to The Health Insurance Portability and Accountability Act (HIPAA) rules where heightened patient privacy protections apply because of the sensitivity of the information.

The HIPAA rule includes information transmitted orally and soundproofing provides a high level of assurance to patients that their information is indeed private. Sound mitigation can also help keep a physician’s practice or healthcare organization out of legal complexities, prevent complaints and possible fines.

In Toronto, a practicing psychologist concerned about patient confidentiality engaged Angelo Papadimitriou of Pro-Tech Solutions in Ajax, Ontario, to reduce the sound in her business office. After a thorough assessment of the acoustic conditions and the structure, Angelo, a general contractor with noise control experience, recommended treating three walls with Acoustiblok sound abatement material, and installing a solid door with a threshold and weather stripping on the bottom to keep the sound of the voices from traveling out.

Acoustiblok, an international award-winning material, is 1/8 inch thick and can easily be applied to a standard stud wall and can result in more sound reduction than 8 inches of poured concrete. Results are independent lab-certified. The thin pliable material is engineered not to stop or absorb sound, but through a unique thermodynamic process Acoustiblok transforms the sound energy into trace amounts of inaudible internal friction energy.

For the psychologist office, Acoustiblok material was applied to the walls past the drop ceiling and up to the upper deck. The specially formulated Acoustiblok caulking and tape were used to form a permanent bond to all joints and penetrations to obtain rated sound reduction values (see photos).

According to Angelo, “The psychologist was thrilled with the results. The office is now very quiet and there is no voice transfer between the walls inside the office or outside the door and hallway. The sound reduction was impressive and the price was reasonable for the quality and performance of the product. I have used Acoustiblok on other projects and will continue use it on projects where noise is an issue in the future.”

Lahnie Johnson, president and founder of Acoustiblok said, “We get a lot of requests from physician offices and healthcare organizations, lawyers, law enforcement, and other professionals where speech privacy is a major issue. One of benefits of using Acoustiblok in the walls is you don’t have to worry about the stringent environment inside the exam room or office."

Acoustiblok is a leader in sound control products and can offer not only the best products for the job, but can also custom design and fabricate certain products for specific needs.

Acoustiblok® Material
Acoustiblok® material is typically applied as part of layered wall, ceiling or floor construction. It is usually stapled to wood studs or screwed to metal studs prior to drywall. It has better sound deadening effectiveness than treatments with lead. A typical 2 x 4 gypsum stud wall is usually 33 to 35 STC. Acoustiblok installed in the stud wall is lab certified at STC 53; better than 8 inches of poured concrete (STC 51). To the human ear this represents over 97% in sound reduction! With 2 layers of Acoustiblok, the STC can be even better. Acoustiblok is UL and ULC approved for use in over 400 wall and floor/ceiling assemblies.

Acoustiblok can be installed on studs before attaching drywall to reduce noise between rooms, over floor joists before the sub floor is attached to reduce the sound from walking (impact noise) as well as, the noise created in the room, on roof trusses to reduce noise from low flying airplanes or busy highways, around plumbing pipes to quiet the sound of running water or in home theaters and multi-functional A/V type entertainment rooms.

In multi units such as condominiums, apartment complexes and office buildings a leading cause of tenant relocation is noise. The problem of sound attenuation in these types of buildings is rarely addressed properly. By installing Acoustiblok during pre-construction over the studs, ceiling and floor joists, sound can be effectively reduced.

QuietFiber®- For Additional Noise Control
To further reduce reflective or reverberant noise in rooms or areas installation of QuietFiber®, a noise absorption material developed by Acoustiblok, is recommended.QuietFiber is engineered specifically for maximum noise absorbency (NRC 1.00) and can be installed throughout the room or area. Areas with high noise levels such as waiting or patient rooms can easily be resolved by introducing as much QuietFiber as possible (under tables, chairs, in cabinets, on top of bookshelves, etc.). Ceiling tiles may also be replaced with the product. White or black-faced QuietFiber is hydrophobic, doesn’t support mold, UV tolerant, non-fiberglass, easy to install, E-84 class A fire rated, 100% recyclable, environmentally-conscious, and entirely made in the USA. It is currently available in various sizes and densities for optimum performance, and is UL rated for floor, wall and ceiling applications.

About Acoustiblok – “Quieting the World”

For over 20 years Acoustiblok, a NASA spinoff listed company, has been a leader in developing and manufacturing products for noise control utilized throughout the world. The company has received the top award in the British House of Commons for sound abatement and was recently shown across the globe on National Geographic TV highlighting its unique contributions towards reducing noise pollution.

Primary products include barium free Acoustiblok® viscoelastic polymer-based soundproofing material, Acoustifence® noise reducing fence, All Weather Sound Panels®, QuietFiber® insulating material, Quiet-Cloud® industrial sound absorption panels, Acoustiblok-Wallcover® post-construction soundproofing material and Thermablok® aerogel (the highest insulation known). Adding just one ¼” x 1½" strip of Thermablok to each stud before drywall can increase the R value of the wall by over 33% regardless of the insulation used in the cavity.

Acoustiblok products are used in the industrial, residential, and commercial sectors earning the industry’s highest ratings from architects, builders, and consumers. The company’s products are made and sourced in the United States. http://www.acoustiblok.com Reported by PRWeb 17 hours ago.

RISE RAPS-EDS Collaboration Research Project

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An Industry Collaboration Study on New CMS Policy on Payment to Medicare Advantage Plans

Nashville, TN (PRWEB) February 16, 2017

The RISE Association announces an executive summary report published by Avalere, an Inovalon company, and technical partner in conducting the data study sponsored by the RISE Association.

Avalere analyzed data from eight Medicare Advantage Organizations (MAOs) representing 1.1 million beneficiaries in more than 30 unique plans operating across the country to understand the impact of shifting the determination of plan risk scores from the Risk Adjustment Processing System (RAPS) to the new Encounter Data System (EDS). Centers for Medicare and Medicaid Services (CMS) intends to transition gradually to EDS-based payments, starting with 10 percent of the payment based on EDS in 2016, increasing to 25 percent in 2017 and 50 percent in 2018.

CMS has said the diagnoses captured in EDS should not be different from those identified in RAPS. However, we found that this transition will significantly reduce the identification of diagnoses used to calculate the risk scores that reflect the disease burden of the plans membership. Average risk scores resulting from the EDS process were 26 percent lower in the 2015 payment year (based on 2014 claims data) and 16 percent lower in the 2016 payment year (based on 2015 claims data) compared to RAPS. The lower risk scores were primarily the result of 35-40 percent fewer Hierarchical Condition Category (HCC) diagnoses identified in EDS compared to RAPS.

The risk score differences will have significant negative implications for MAOs and the 18 million beneficiaries they serve. As an example, using an $800 bid rate, if there had been a full transition from RAPS to EDS in 2016, this would equate to an average reduction of 16.1 percent in PMPM rates, representing a decrease of $260.4 million per year for the average plan in our study. The 90/10 phase in in 2016 would result in a 1.6% reduction in PMPM rates which would translate to $25.2 million per-plan in lower payments on average.

In spite of recent actions taken by CMS to improve EDS, a new Government Accountability Office (GAO) report documents numerous problems MA plans have had in submitting data and receiving reliable edits from the agency.

A full report including extensive detailed information from the study will be released in February 2017.

For more information and full agenda details please visit: https://goo.gl/zB3SVR

CMS 2017 Final Rate Announcement (April 4, 2016), p. 61. Found at https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf

GAO-17-223 (January 2017) found at http://www.gao.gov/assets/690/682145.pdf Accessed on January 20, 2017

About the RISE Association
The RISE Association (Resource Initiative & Society for Education) is a national association dedicated to supporting the healthplan and provider organizations involved in the healthcare reform movement, particularly those involved in the government programs markets such as Medicare Parts C & D, Affordable Care Act health insurance exchanges, special needs plans for dually-eligible individuals, Medicaid plans for needy populations, Accountable Care Organizations and MACRA initiatives.

Our vision is to build a community and an educational system that promotes successful careers for professionals who are advancing the Triple Aim of healthcare. RISE provides:·     A forum to build professional identity and a network of colleagues
·     A platform to capture and share knowledge and insights
·     A venue to develop and share benchmarks and document best practices
·     Career track development support
·     A channel for building alliances, partnerships and affiliations that fulfill the vision Reported by PRWeb 17 hours ago.

ez1095 ACA Software From Halfpricesoft.com Offers Feature To Import From Spreadsheet

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ez1095 2016 software created with data import feature for new customers. Visit http://www.halfpricesoft.com for more details.

Detroit, MI (PRWEB) February 16, 2017

Halfpricesoft.com has updated ez1095(ACA software)with a data import feature for new customers to import from spreadsheet. The latest release offers single and multi user versions, printing and efile options and easy instructions for rolling forward from last year data to this year for current customers.

“ez1095 2016 ACA form reporting software now offers spreadsheet import capability for ease of use.” said Dr. Ge, the founder of Halfpricesoft.com.

Ez1095 can support 1095C, 1094C, 1095B and 1094B forms paper printing, pdf printing and efiling. The software has been submitted and approved by the SSA to print on plain white paper, saving form costs. Its quick data import feature saves customers valuable time and speeds up tax form filing.

ez1095 software has been created and released to follow the requirements set by the government to file forms 1094 and 1095 starting in 2016. ez1095 software’s graphical interface accommodates customers in company setup, adding employees, adding forms and printing forms immediately after download. Customers can also click form level help links to get more details regarding the software.

Ez1095 ACA software is compatible with Windows 10, 8.1, 8, 7, Vista and other Windows system. Customers can run this desktop ACA software offline to protect employee data. Download and try it at no cost or obligation at http://www.halfpricesoft.com/aca-1095/aca-1095-software.asp

General features include-· Print Form 1095 C: Employer-Provided Health Insurance Offer and Coverage Insurance
· Print Form 1094 C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
· Print Form 1095-B: Health Coverage
· Print Form 1094-B: Transmittal of Health Coverage Information Return
· Print recipient copies in PDF format.
· Support unlimited companies.
· Support unlimited number of recipients.
· Fast data import feature
· Print ACA forms 1095 and 1094 on blank paper with inkjet or laser printer.
· Print unlimited number of 1095 and 1094 forms.

Priced at just $195, ($295 for efile version) this ACA forms filing software saves employers time and money. To learn more about ez1095 ACA software, customers can visit http://www.halfpricesoft.com/aca-1095/aca-1095-software.asp

About halfpricesoft.com
Founded in 2003, Halfpricesoft.com has established itself as a leader in meeting the software needs of small businesses around the world with its payroll software, employee attendance tracking software, check printing software, W2 software, 1099 software and bar-code generating software. It continues to grow with its philosophy that small business owners need affordable, user friendly, super simple, and totally risk-free software. Reported by PRWeb 11 hours ago.

RevSpring Maintains Commitment to Security with PCI DSS and SOC 2 Type 2 Renewal

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RevSpring Maintains Commitment to Security with PCI DSS and SOC 2 Type 2 Renewal

WIXOM, Mich. (PRWEB) February 16, 2017

RevSpring has again maintained its commitment to security and compliance by successfully meeting the necessary criteria to complete the AT 101 SOC 2 Type 2 audit under the American Institute of Certified Public Accountants (AICPA) guidelines. RevSpring has also completed PCI DSS 3.2 certification.

Benefits of completing SOC 2 include:·     Improved standing with customers focused on privacy and confidentiality
·     Insight into best practices with regard to security controls and established procedures
·     More comprehensive awareness for management and its impact on risk assessment

The SOC 2 examination conducted by Auditwerx, a leading provider of CPA auditor assurance engagements, included a second auditor this year to ensure sufficient separation of duties. The audit provided a thorough review of RevSpring’s policies and practices in the following areas:

·     Security: The system is protected against unauthorized access (both physical and logical).
·     Availability: The system is available for operation and use as committed or agreed.
·     Processing Integrity: System processing is complete, accurate, timely, and authorized.
·     Confidentiality: Information designated as confidential is protected as committed or agreed.

The PCI DSS v3.2 audit was conducted by Solutionary. A fundamental component of RevSpring’s certification is the decommissioning of TLS 1.0, a key part of the company’s strategic plan for 2017.

RevSpring has also completed the third-party assessment against additional security and privacy standards to ensure its continued position as an industry leader. The regulations that RevSpring had their security controls assessed against include the following:

·          HIPAA/HITECH (Health Insurance Portability and Accountability Act of 1996)
·         ISO 27001:2013 (Information Security Management Systems)
·         NIST 800-53 R4 (Federal Information Security Management Act of 2002)
·         GLBA (Financial Services Modernization Act of 1999)
·         MASS 201 (Massachusetts Standards for the Protection of Personal Information of Residents of the Commonwealth)
·         NRS 603A (Nevada Security of Personal Information)

“RevSpring is dedicated to achieving the highest level of internal controls and compliance standards throughout operations,” said Peter David, RevSpring’s chief security officer. “Annually completing these valuable audits confirms the importance we place in our compliance program.”

About RevSpring
RevSpring facilitates over one billion customer interactions annually, serving more than 2,000 clients across the accounts receivables management, healthcare, financial services, and other end-markets. RevSpring’s billing and consumer communication platform allows organizations to receive payments faster with more communication options, including mail, web, text, and phone. In addition, RevSpring improves the workflow, design and distribution of consumer communications to make interactions more impactful, meaningful, and effective. For more information, visit http://www.revspringinc.com.

###

Contact:
Heather Taylor                            
765.730.6632                            
htaylor(at)revspringinc.(dot) Reported by PRWeb 12 hours ago.

Key Events In Washington Today

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Key Events In Washington Today While less exciting than yesterday, when Trump again praised his stupendous, "imminent" tax plan while meeting with retail CEOs complaining about border adjustment, before telling Netanyahu he is ok with either a one or "two-state" solution, all eyes will again remain focused on DC, and - of course - the biggest wildcard, Donald Trump. Here’s a look at scheduled events of interest today in Washington, courtesy of Bloomber; all times Eastern 

· Senate vote on nomination of Rep. Mick Mulvaney to lead Office of Management and Budget
· Senate cmte hearings to consider nominations of David Friedman to be U.S. ambassador to Israel and Seema Verma to lead Centers for Medicare and Medicaid Services

*WHITE HOUSE*

· 10:30am: President Trump participates in Congressional listening session
· 1:25pm: Trump speaks with President Beji Caid Essebsi of Tunisia in phone call
· 3:15pm: Trump signs H.J. Res. 38, repealing coal mining waste rule
· 1:30pm: Briefing with Press Sec. Sean Spicer

*CONGRESS: *

· House meets at 10am; plans to consider two resolutions to overturn Obama administration rules under the Congressional Review Act
· Senate meets at 10am
· 10:30am: Senate to hold vote on Mulvaney to lead the OMB; then cloture vote on Scott Pruitt to lead EPA
· 10am: Senate Rules and Administration Cmte meets to “organize the 115th Congress and to consider the omnibus budget resolution” for committees; 301 Russell
· Senate Health, Education, Labor and Pensions Cmte had scheduled a hearing for Andrew Puzder to be U.S. Labor sec.; however, the CKE Restaurants CEO withdrew from consideration Wednesday afternoon

*BUDGET/ECONOMY: *

· 9am: Brookings Institution holds discussion on “Pursuing Regulatory Excellence: Brexit, Trump and Beyond”; 1775 Massachusetts Ave. NW, Saul/Zikha room
· 2pm: Bloomberg Government holds webinar on the look-ahead for congressional budgeting this year, including reconciliation legislation to repeal parts of Obamacare and Trump’s first budget request

*DEFENSE: *

· 9am: House Armed Services Cmte’s Tactical Air and Land Forces panel holds hearing on 5th generation tactical aircraft challenges and the F-35 joint strike fighter program; 2212 Rayburn
· 9:30am: Senate Armed Services Cmte holdings hearing on “Reshaping the U.S. Military”; G-50 Dirksen

· *HEALTH: *
· 8am: Joint Economic Cmte Chairman Pat Tiberi, R-Ohio, joins Ripon Society discussion on Republican strategy to replace Obamacare; Capitol Hill Club, 300 First St. SE
· 10am: House Judiciary Cmte, Regulatory Reform, Commercial and Antitrust Law panel holds hearing on H.R. 372, the “Comprehensive health Insurance Reform Act of 2017”; 2141 Rayburn
· 10am: Senate Finance Cmte to hold hearing on nomination of Seema Verma to lead CMS; 215 Dirksen
· THURS-FRI: House Democratic Leader Nancy Pelosi; Sen. Al Franken, D-Minn.; Sen. Chris Van Hollen, D-Md.; Sen. Debbie Stabenow, D-Mich.; and Rep. Bobby Scott, D-Va., address Families USA’s Health Action 2017 conference; Hyatt Regency Washington on Capitol Hill, 400 New Jersey Ave. NW

*STATE/TRADE: *

· 10am: House Foreign Affairs Cmte holds hearing titled “Iran on Notice”; 2172 Rayburn
· 10:30am: Senate Foreign Relations Cmte holds hearing to consider nomination of David Friedman to be U.S. ambassador to Israel; 419 Dirksen

*TECHNOLOGY/TELECOM *

· 10am: Sens. Chris Coons, D-Del., and Thom Tillis, R-N.C., join Information Technology and Innovation Foundation’s discussion on “Workforce Retraining: What America Can Learn From the World”; 385 Russell

Source: Bloomberg Reported by Zero Hedge 11 hours ago.

United States: What And How Obamacare Is Doing At The Court Of Federal Claims - Mayer Brown

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Millions of Americans who were able to obtain health insurance as a result of the Patient Protection and Affordable Care Act are waiting to learn the extent to which Congress Reported by Mondaq 9 hours ago.

10 More Members of President's Advisory Commission on Asian Americans and Pacific Islanders Resigned

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The President's Advisory Commission on Asian Americans and Pacific Islanders yesterday submitted their resignations to President Trump. The main reason: Trump's policies that have adversely affected Asian Americans and Pacific Islanders.

Six other Commissioners--Nina Ahmad, Lian Cheun, Diane Narasaki, Shekar Narasimhan, Bo Thao-Urabe, and Paul Watanabe--had resigned last month.

"We had significant concerns about the Trump Administration's policies regarding issues crucial to AAPI communities such as immigration, health care, and education," said Dr. Tung Nguyen, former Chair of the Commission. "As a practicing physician, I saw how much good the Affordable Care Act (ACA) did for patients. Under the ACA, which the Administration seeks to repeal, over 2 million AAPIs obtained health insurance. Now, there is so much anxiety about not being able to get health insurance or treatment for severe illnesses."

"February 19, 2017 will be the 75th anniversary of the signing of Executive Order 9066 which led to the incarceration of 120,000 Japanese Americans during World War II. Protecting civil rights and fighting against bullying were pillars of our Commission's work. We cannot serve under an administration that seeks to exclude members of our society or take away their rights, especially the Muslim community, which is very much part of our AAPI community," stated former Commissioner Maulik Pancholy.Below is their open letter to President Trump.February 15, 2017

The Honorable Donald J. Trump President of the United States The White House
1600 Pennsylvania Avenue, NW Washington, DC 20500

Dear President Trump:

We, the undersigned, members of the President's Advisory Commission on Asian Americans and Pacific Islanders (AAPIs) resign from our appointments effective immediately. We sent to you a letter on 1/13/17 stating the goals and principles that defined our work as Commissioners but have received no response. Although the Commissioners' term ends 9/30/17, we can no longer serve a President whose policies aim to create outcomes that are diametrically opposite to our principles, goals, and charge.

Under Presidents Clinton, Bush, and Obama, the charge to Commissioners has been to help the federal government better serve AAPIs by engaging our communities, identifying our needs and priorities, and increasing access to our government. The Commissioners have engaged with AAPIs throughout our country, from all walks of life, and across the political spectrum using the following principles that are fundamental to our work:

• Protecting the civil rights of all those living in our country, including the most vulnerable;

• Respecting the unique attributes of all individuals and communities;

• Promoting family values by keeping families together and reuniting those separated by
immigration; and

• Ensuring linguistic, cultural, and financial access to health care as well as economic and
educational opportunities for all.

We firmly believe these principles are fundamental to our nation and need to be implemented and enforced at all times. Since your Inauguration, the Executive Orders you have issued and policies you promulgated have greatly impeded the ability of the federal government to serve all who live here.

Specifically, your actions have had the following deleterious consequences for AAPIs and for all Americans:

• Proposals to cut federal resources to sanctuary cities will harm all residents of those cities by reducing support for critical municipal services such as police, fire, health, and emergency services. These actions will fuel tensions between native-born Americans and immigrants--regardless of their status. Two out of three AAPIs are immigrants.

• Bans on refugees and those coming from the seven predominantly Muslim countries have torn families apart, have created confusion about our immigration and visa policies, and have created tension with countries that we need to better understand. By singling out individuals, families and communities for their religious beliefs, your actions create a
religion-based test for entry into our country and threaten freedom of religion, a fundamental constitutional right. Banning Muslims bans members of our AAPI community.

• Increased border and immigrant enforcement, as well as building a wall between Mexico and the United States, will not improve the security of our country. Rather, it will split working families apart, severely impact companies and their workforce, and exacerbate tensions with a key ally and trading partner. Many AAPI individuals and businesses depend on good international relations for personal and economic reasons.

• Repealing the Affordable Care Act (ACA) will harm at least 20 million Americans who were previously uninsured, two million of whom are Asian Americans, Native Hawaiians and Pacific Islanders, along with millions more who benefited from key provisions of the ACA.

In addition to these actions, we object to your portrayal of immigrants, refugees, people of color and people of various faiths as untrustworthy, threatening, and a drain on our nation. The fact is that Native Peoples, immigrants from all parts of the world, and people of color have built this country. Among the Commissioners, there are immigrants, refugees, and descendants of those who have experienced systematic discrimination. We, and the communities that we represent, have worked diligently to make America great and have fought to keep it free. We have and will always strive to ensure that America, our America, will never go back to the days of exclusion, segregation, and internment - all policies which have severely impacted AAPIs.

AAPIs are an integral part of the mosaic of our great country and have been since the 1500s. We share the same dreams as other Americans for a stronger, brighter and more inclusive America. We urge you and every member of your Administration to respect all Americans by protecting civil rights and civil liberties for everyone, promoting broader dialogue and understanding, and keeping the federal government accessible to all people living in the United States - regardless of their status as citizens, immigrants or refugees.
Sincerely,

Tung T. Nguyen, MD, Chair. Vietnamese American, San Francisco, California Mary Okada, Co-Chair. Chamorro American, Guam

Michael Byun, Commissioner. Korean American, Akron, Ohio

Kathy Ko Chin, Commissioner. Chinese American, Oakland, California
Jacob Fitisemanu, Jr., Commissioner. Samoan American, Salt Lake City, Utah Daphne Kwok, Commissioner. Chinese American, Annandale, Virginia

Dee Jay Mailer, Commissioner. Native Hawaiian, Honolulu, Hawaii

Maulik Pancholy, Commissioner. Indian American, Brooklyn, New York Linda Phan, Commissioner. Vietnamese American, Austin, Texas

Sanjita Pradhan, Commissioner. Nepalese American, Des Moines, Iowa

cc: Secretary Betsy DeVos, Department of Education
Surgeon General Vivek Murthy, MD, Co-Chair, White House Initiative on AAPIs

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 8 hours ago.

U.S. Health Care Costs Will Outpace GDP Within A Decade

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WASHINGTON (Reuters) - The cost of medical care in the United States is expected to grow at a faster clip over the next decade and overall health spending growth will outpace that of the gross domestic product, a U.S. government health agency said on Wednesday.

A report by the U.S. Centers for Medicare and Medicaid Services (CMS) cited the aging of the enormous baby boom generation and overall economic inflation as prime contributors to the projected increase in healthcare spending.

Overall healthcare spending will comprise 19.9 percent of the economy in 2025, up from 17.8 percent in 2015, the report forecast. The pace of growth in U.S. spending on health is expected to pick up in 2017, increasing 5.4 percent over 2016. That compares with an estimated 4.8 percent spending uptick in 2016. Spending for 2016 was estimated at $3.4 trillion.

When the final numbers are in, the growth in prescription drug spending for 2016 is expected to have slowed to 5 percent from 9 percent in 2015. However, CMS has forecast growth of 6.4 percent per year between 2017 and 2025, in part because of spending on expensive newer specialty drugs, such as for cancer and multiple sclerosis.

The projections for 2016 to 2025 were made assuming that the Affordable Care Act (ACA), former President Barack Obama’s signature healthcare law widely known as Obamacare, would remain intact. It does not take into account likely changes to the law.

The Republican-led Congress and President Donald Trump have vowed to repeal and replace the ACA, but a viable replacement plan has yet to emerge.

Trump signed an executive order on his first day in office last month to freeze regulations and enable government agencies to take other steps to weaken Obamacare.

The ACA expanded Medicaid, the government health insurance program for the poor, in more than 30 states and set up private healthcare exchanges that enabled previously uninsured people to buy health insurance. After high enrollment between 2014 and 2015, Medicaid and privatehealth insurance spending were expected to have slowed in 2016.

But spending on Medicare, the government health insurance program for the elderly, is expected to grow between 2017 and 2025 as a larger elderly population requires more medical services.

The overall insured rate of the population is expected to reach 91.5 percent in 2025, up from 90.9 percent in 2015, the report said.

 

(Reporting By Yasmeen Abutaleb; Editing by Tom Brown)

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 8 hours ago.

Trump health pick says maternity coverage should be optional

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WASHINGTON (AP) " President Donald Trump's pick to lead the government's major health insurance programs says maternity coverage should be optional for patients.Indiana health care consultant Seema Verma tells the Senate Finance... Reported by New Zealand Herald 8 hours ago.

HPOne Names Michelle Zettergren as Chief Sales Officer, Company Expands Leadership Team for Continued Growth

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HPOne today has announced the appointment of Michelle Zettergren as the Company’s Chief Sales Officer. Ms. Zettergren will be based in the Trumbull, CT headquarters with responsibility for all sales and account management activities, reporting to HPOne CEO Bill Stapleton.

TRUMBULL, Conn (PRWEB) February 16, 2017

HPOne today has announced the appointment of Michelle Zettergren as the Company’s Chief Sales Officer. Ms. Zettergren will be based in the Trumbull, CT headquarters with responsibility for all sales and account management activities, reporting to HPOne CEO Bill Stapleton.

“Michelle’s experience in the health insurance industry, particularly on the carrier side of the business, will be invaluable in helping HPOne identify and deliver solutions to meet the goals of our customers while expanding our roster of clients. We are excited to add her deep industry knowledge and entrepreneurial spirit to the team, and look forward to her contributing to the growth of the business,” commented Bill Stapleton, CEO of HPOne.

Ms. Zettergren brings over 20 years of experience in the health insurance industry, most recently as the Senior Vice President and Chief Sales and Marketing Officer for ConnectiCare, a subsidiary of EmblemHealth. In her role, Michelle led ConnectiCare's efforts in the commercial and Medicare segment with ownership for sales, account management, product, underwriting, group reporting, marketing, communications and public relations. During her tenure, ConnectiCare achieved historic levels of membership and #1 market position in Medicare, Individual and Small Group markets. Prior to ConnectiCare, Ms. Zettergren spent nearly 14 years at Anthem in various roles including Regional VP of Underwriting.

About HPOne

Founded in 2006, HPOne is a leading sales and marketing organization that operates across multiple segments of the Medicare and health insurance marketplaces. Using proprietary technology solutions coupled with deep industry knowledge, the company provides a range of outsourced sales, marketing and contact services for national and regional health plans, operates private exchanges for individual consumers and employer-based group retirees, and manages the largest exclusive Medicare lead generation marketplace in the industry. HPOne’s core differentiation is its exclusive focus on the health insurance industry, bringing innovative and performance-based solutions that address the most pressing challenges facing clients. With four state-of-the-art contact centers around the country and a management team with an average of over 15 years in the health insurance industry, HPOne provides its clients with the solutions they need to profitably grow and manage their business. For more information, visit http://www.HPOne.com. Reported by PRWeb 7 hours ago.

The Latest: Health nominee says no to vouchers for Medicare

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"Voucher" is a term used by critics to describe a proposal under which retirees would get a fixed payment to purchase coverage from government-regulated private insurance plans. President Donald Trump's pick to lead the government's major health insurance programs says maternity coverage should be optional for patients. Indiana health care consultant Seema Verma tells the Senate Finance Committee that patients — not the government — should determine the insurance benefits they need. Republicans have criticized the law's requirement that insurers cover a standard set of "essential" benefits, including women's health services. Reported by SeattlePI.com 7 hours ago.

Allianz SE: Strong net income and balance sheet

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DGAP-News: Allianz SE / Key word(s): Quarter Results/Final Results

16.02.2017 / 18:53
The issuer is solely responsible for the content of this announcement.

---------------------------------------------------------------------------

Full-year highlights

* 2016 operating profit up 0.9 percent to 10.8 billion euros, near upper
end of target range
* 2016 net income attributable to shareholders up 4.0 percent on year to
6.9 billion euros
* Solvency II capitalization rises to 218 percent at December 31, 2016
compared to 200 percent one year ago
* Board of Management proposes to raise the dividend further to 7.60 euros
per share from 7.30 euros
* Allianz to launch a share buy-back program worth up to 3 billion euros
* Operating profit target for 2017 is 10.8 billion euros, plus or minus 500
million euros, barring unforeseen eventsFourth-quarter highlights

* 4Q operating profit up 9.3 percent on year to 2.8 billion euros
* 4Q net income attributable to shareholders up 23 percent on year to 1.7
billion euros
* 4Q combined ratio improves to 94.0 percent from 96.2 percent year-ago
* New business margin strong at 2.9 percent in 4Q
* PIMCO third-party net inflows at 5.9 billion euros in 4Q
* 4Q cost-income ratio in Asset Management improves by 1.7 percentage
points to 61.4 percent
Allianz 2016: Another successful year

Allianz Group delivered 10.8 billion euros in operating profit in 2016,
near the upper end of its target range and the fifth consecutive increase
in annual operating results. Net income attributable to shareholders rose
4.0 percent compared to 2015, leading Allianz to raise its dividend further
to 7.60 euros. Allianz will also launch a 12-month share buy-back plan
worth up to 3 billion euros, representing around 4.2 percent of its share
capital. Allianz, Europe's largest insurer by market value, saw further
progress in implementing its Renewal Agenda in 2016, putting the company
well on track to achieve its 2018 targets.

The Life and Health segment saw the strongest rise in operating profit - up
9.3 percent to 4.1 billion euros - with rising investment results as the
key driver. The new business margin rose to 2.7 percent in 2016 compared to
2.2 percent in 2015, demonstrating Allianz's ability to implement strategic
changes swiftly and profitably in response to the low interest rate
environment.

The Property and Casualty segment saw operating result ease 4.2 percent in
the year mainly due to weaker investment results, even as its underwriting
performance improved. The segment's combined ratio, which measures
underwriting profitability, improved 0.3 percentage points to 94.3 percent
due in part to lower claims from natural catastrophes.

The Asset Management segment marked an important milestone as PIMCO
generated two consecutive quarters of third-party net inflows in the second
half of 2016. A 6.1 percent increase of total assets under management (AuM)
to 1,871 billion euros at year-end was mainly due to positive market
effects. A decline in AuM driven fees and performance fees, however, led to
a 4.0 percent decrease in operating profit. Cost discipline led to an
improvement in the cost-income ratio to 63.4 percent from 64.5 percent for
the segment.

"Allianz had a great year in 2016, with efforts invested in our Renewal
Agenda starting to bear fruit. All segments delivered well, thanks to the
engagement of our excellent people, and our robust capital base puts us in
a position of strength," Oliver Bäte, Chief Executive Officer of Allianz
SE, said.

"The year was filled with surprises, not all of them welcome, that
challenged many assumptions, fueled geopolitical uncertainty and market
volatility, and that make 2017 difficult to predict. Nevertheless, we feel
confident enough to raise our operating profit target range. The group aims
to achieve an operating result of 10.8 billion euros, plus or minus 500
million euros, in 2017, barring unforeseen events, crises or natural
catastrophes," Oliver Bäte stated.


Allianz returns unused capital to shareholders

Allianz SE has decided to launch a share buy-back program with a volume of
up to 3 billion euros as part of a previously announced plan to return
unused capital from the group's budget for external growth from the period
2014 to 2016. Based on the closing price of 156.85 euros per share on
February, 10, 2017, this would represent approximately 19.1 million shares
or 4.2 percent of share capital.

The share buy-back program is envisaged to start on February 17, 2017 and
last no longer than 12 months. Allianz SE will cancel repurchased shares
and regularly publish updates on the program. The full implementation of
the program as scheduled is subject to a minimum sustainable Solvency II
ratio of 160 percent.Capital management becomes more flexible

Through capital management, Allianz Group aims for a healthy balance
between an attractive yield and investment in profitable growth. In 2014,
Allianz Group adjusted the payout ratio to shareholders to 50 percent of
net income attributable to shareholders. The Group also set aside 20
percent of net attributable income each year for external growth and aimed
to pay out any unused portion of this budget every three years starting at
the end of 2016.

The Board of Management and the Supervisory Board have now decided to
simplify Group capital management to make it more flexible. In future, 50
percent of Group net attributable income will still be returned to
shareholders in the form of a regular dividend. Allianz also aims to keep
the regular dividend per share at least at the level paid in the previous
year.

However, Allianz no longer intends to link its budget for external growth
to shareholder pay-outs in a three-year cycle. Rather, half of net income
should be used as deemed appropriate to finance growth, or it will be
returned to shareholders on a flexible basis. This remains subject to a
sustainable Solvency II ratio above 160 percent [I].


Group: Life and Health performance drives 2016 income growth

2016 EPS up 4% to EUR15.14

Operating profit in 2016 rose 0.9 percent compared to one year ago to 10.8
billion euros, near the upper end of the target range. Net income growth
was driven by a 9.3 percent improvement in operating profit in the Life and
Health segment, largely due to an increased investment margin.
The non-operating loss was unchanged compared to one year ago, including
the negative impact from the sale of the South Korean business.
Overall, net income attributable to shareholders grew 4.0 percent to 6.9
billion euros. Basic Earnings per Share (EPS) rose 4.0 percent to 15.14
euros.
Return on equity was at 12.0 percent in 2016 (2015: 12.5 percent), as
capital strength grew faster than earnings.

4Q operating profit up 9.3% to EUR2.8bn

Operating profit increased 9.3 percent to 2.8 billion euros in the fourth
quarter, largely due to a stronger underwriting result in the Property and
Casualty segment, where operating profit rose 16.4 percent.

4Q net income up 23.0%

An improved non-operating result also supported the increase in net income
attributable to shareholders, which rose 23.0 percent to 1.7 billion euros
in the fourth quarter. Basic Earnings per Share (EPS) in the quarter
increased to 3.83 (3.12) euros.

Solvency II capitalization ratio 218% at year-end

The Solvency II capitalization ratio rose to 218 percent at the end of 2016
compared to 200 percent on December 31, 2015. This was primarily due to
operating capital generation and the sale of our Korean life insurance
operations.

2016 management assessment

"Allianz enjoyed a stellar finish in 2016 despite tough market conditions,
leading management to propose another dividend increase. The company
recorded its fifth consecutive rise in annual operating profit, supported
by continued positive developments in all business segments and putting the
group on track to meet its 2018 Renewal Agenda targets," said Dieter
Wemmer, Chief Financial Officer of Allianz SE.


Property and Casualty insurance: 2016 internal growth stays strong

Full Year 2016 internal growth at 3.1%

In 2016, gross premiums written held steady at 51.5 (51.6) billion euros.
Adjusted for foreign exchange and consolidation effects, internal growth
was strong at 3.1 percent, mostly driven by positive developments in
Turkey, Germany, and at Allianz Worldwide Partners. Operating profit for
2016 eased 4.2 percent to 5.4 billion euros compared to 2015 due to lower
investment income. The combined ratio for the full year improved by 0.3
points to 94.3 percent.

4Q gross premiums written up 2.4%

Gross premiums written rose 2.4 percent to 11.2 billion euros in the fourth
quarter in the segment. Adjusted for foreign exchange and consolidation
effects, internal growth was 3.6 percent, driven by a positive volume
effect of 2.0 percent and a positive price effect of 1.6 percent.

4Q combined ratio better at 94.0%

Operating profit increased 16.4 percent to 1.4 billion euros in the fourth
quarter compared to the same quarter in the previous year in the segment.
The underwriting result improved, benefiting from lower claims from natural
catastrophes and large losses. The combined ratio improved 2.3 percentage
points to 94.0 percent.

4Q management assessment

"Growth improved in Property and Casualty in the quarter with both volume
and price contributing to a better result. Allianz Worldwide Partners and
Turkey helped to drive growth, as did Germany," said Dieter Wemmer. "We are
moving steadily toward our goal of a 94 percent combined ratio by 2018."Life and Health insurance: 2016 investment margin drives rise in operating
profit

Full Year 2016 shows sustainable gains in new business margin

In Life and Health insurance, operating profit for the year increased 9.3
percent to 4.1 billion euros. This was driven by a higher investment
margin. The targeted shift toward capital-efficient products was reflected
in the rise of the new business margin to 2.7 percent for the full year. As
a result, the value of new business (VNB) rose 21.7 percent to 1.4 billion
euros compared to 2015.

4Q operating profit EUR1.1bn

Operating profit decreased 1.7 percent to 1.1 billion euros compared to the
prior-year quarter in the segment, partly due to increased policyholder
participation in Germany, offset by the higher investment margin in the
United States.

VNB EUR420mn and NBM 2.9% in 4Q

The value of new business (VNB) increased 6.4 percent to 420 million euros
in the quarter. The new business margin remained stable at 2.9 percent. Due
to changes in strategy, premiums shifted to capital-efficient products, but
lower market yields weighed on results.

4Q management assessment

"Allianz is quickly switching toward Life products that can produce better
returns for customers. This strategic shift has benefited Allianz
shareholders as well, as reflected in a new business margin of 2.9 percent
in the last quarter of 2016," said Dieter Wemmer.Asset Management: PIMCO flows stay positive in 4Q; efficiency improves

Full Year 2016 sees better cost-income ratio

Third-party assets under management (AuM) increased by 85 billion euros in
2016, mostly due to positive market effects. Operating revenues decreased
7.1 percent to 6.0 billion euros, mainly due to lower AuM driven fees,
primarily affected by decreased fee margins. As expected, operating profit
decreased 4.0 percent to 2.2 billion euros in 2016, as a decline in
revenues could only partially be compensated by a reduction of operating
expenses. Lower personnel costs at PIMCO contributed to an overall drop of
8.7 percent in operating expenses in the segment. The cost-income ratio
(CIR) improved to 63.4 percent from 64.5 percent last year.

4Q operating profit at EUR640mn

Operating profit edged higher in the fourth quarter of the year, amounting
to 640 million euros, as falling operating expenses more than compensated
for lower operating revenues in the segment.

CIR at 61.4% in 4Q

The cost-income ratio (CIR) for the segment improved 1.7 percentage points
to 61.4 percent in the quarter as cuts in operating expenses outpaced the
fall in revenues. At PIMCO the cost-income ratio improved to 56.9 percent
(4Q 2015: 60.2 percent).

3P net inflows at EUR1.7bn in 4Q

Compared to September 30, 2016, third-party AuM rose by 34 billion euros to
1,361 billion euros at the end of the fourth quarter, mostly due to
favorable foreign exchange effects. The quarter saw third-party net inflows
of 1.7 billion euros, driven by net inflows of 5.9 billion euros at PIMCO,
partly offset by net outflows of 4.2 billion euros at Allianz Global
Investors.

4Q management assessment

"The PIMCO turnaround is on track as the fourth quarter was the second
consecutive reporting period with positive third-party net inflows. Cost
cuts, especially in variable compensation, helped to make up for revenue
declines and lift operating profit slightly in the quarter," said Dieter
Wemmer.
[I] This represents the management's current intention and may be revised
in the future. Also, the decision regarding dividend payments in any given
year is subject to specific dividend proposals by the management and
supervisory boards, each of which may elect to deviate if appropriate under
the then prevailing circumstances, as well as to the approval of the annual
general meeting.

Allianz Group - preliminary key figures 4th quarter and fiscal year 2016

4Q 2016 4Q 2015
Total revenues [Euro bn] 30.0 29.7
Property-Casualty [Euro bn] 11.2 10.9
Life/Health [Euro bn] 17.1 17.0
Asset Management [Euro bn] 1.7 1.7
Corporate and Other [Euro bn] 0.2 0.2
Consolidation [Euro bn] -0.1 -0.1

Operating profit / loss [Euro mn] (1) 2,826 2,586

Property-Casualty [Euro mn] 1,421 1,221
Life/Health [Euro mn](1) 1,083 1,101
Asset Management [Euro mn] 640 637
Corporate and Other [Euro mn] -302 -368
Consolidation [Euro mn] -16 -5

Net income [Euro mn] 1,826 1,499
attributable to non-controlling interests [Euro mn] 82 81
attributable to shareholders [Euro mn] 1,744 1,418

Basic earnings per share [Euro] 3.83 3.12
Diluted earnings per share [Euro] 3.83 3.12

Additional KPIs
Group: Return on Equity (3)(4)
Property/Casualty: Combined ratio 94.0% 96.2%
Life/Health: New business margin (5) 2.9% 2.9%
Life/Health: Value of new business[Euro mn](5) 420 395
Asset Management: Cost-income ratio 61.4% 63.0% 12M 2016 12M 2015
Total revenues [Euro bn] 122.4 125.2
Property-Casualty [Euro bn] 51.5 51.6
Life/Health [Euro mn] 64.6 66.9
Asset Management [Euro bn] 6.0 6.5
Corporate and Other [Euro bn] 0.6 0.6
Consolidation [Euro bn] -0.3 -0.4

Operating profit /loss [Euro mn](1) 10,883 10,735

Property/Casualty [Euro mn] 5,370 5,603
Life/Health [Euro mn] (1) 4,148 3,796
Asset Management [Euro mn] 2,205 2,297
Corporate and Other [Euro mn] -867 -945
Consolidation [Euro mn] -23 -16

Net income [Euro mn] 7,250 6,987
attributable to non-controlling interests [Euro mn] 367 371
attributable to shareholders [Euro mn] 6,883 6,616

Basic earnings per share [Euro] 15.14 14.56
Diluted earnings per share [Euro] 15.00 14.55
Dividend per share [Euro] 7.60(2) 7.30Additional KPIs
Group: Return on Equity (3)(4) 12.0% 12.5%
Property/Casualty: Combined ratio 94.3% 94.6%
Life/Health: New business margin (5) 2.7% 2.2%
Life/Health: Value of new business [Euro mn] (5) 1,448 1,190
Asset Management: Cost-income ratio 63.4% 64.5%

12/31/16 12/31/15Shareholders' equity [Euro bn](3) 67.3 63.1
Solvency II capitalization ratio(6) 218% 200%
Third-party assets under management [Euro bn] 1,361 1,276

Please note: The figures are presented in millions of Euros, unless
otherwise stated. Due to rounding, numbers presented may not add up
precisely to the totals provided and percentages may not precisely reflect
the absolute figures.

(1) From the classification of our Korean life business as "held for sale"
in 2Q 2016 until its disposal in 4Q 2016, the total result was
considered as non-operating.
(2) Proposal
(3) Excluding non-controlling interests.
(4) Excluding unrealized gains/losses on bonds net of shadow accounting.
(5) Current and prior year figures are presented excluding effects from the
Korean life business.
(6) Risk capital figures are group diversified at 99.5% confidence level.
Allianz Life US included based on third country equivalence with 150%
of RBC CAL since September 30, 2015. Changed regulatory tax treatment
of German life sector reduced year-end SII capitalization ratio from
200% to 196% on January 1, 2016.
Munich, February 16, 2017

These assessments are, as always, subject to the disclaimer provided below.

Cautionary note regarding forward-looking statements
The statements contained herein may include prospects, statements of future
expectations and other forward-looking statements that are based on
management's current views and assumptions and involve known and unknown
risks and uncertainties. Actual results, performance or events may differ
materially from those expressed or implied in such forward-looking
statements.
Such deviations may arise due to, without limitation, (i) changes of the
general economic conditions and competitive situation, particularly in the
Allianz Group's core business and core markets, (ii) performance of
financial markets (particularly market volatility, liquidity and credit
events), (iii) frequency and severity of insured loss events, including
from natural catastrophes, and the development of loss expenses, (iv)
mortality and morbidity levels and trends, (v) persistency levels, (vi)
particularly in the banking business, the extent of credit defaults, (vii)
interest rate levels, (viii) currency exchange rates including the
euro/US-dollar exchange rate, (ix) changes in laws and regulations,
including tax regulations, (x) the impact of acquisitions, including
related integration issues, and reorganization measures, and (xi) general
competitive factors, in each case on a local, regional, national and/or
global basis. Many of these factors may be more likely to occur, or more
pronounced, as a result of terrorist activities and their consequences.

No duty to update
The company assumes no obligation to update any information or
forward-looking statement contained herein, save for any information
required to be disclosed by law.

Other
The figures regarding the net assets, financial position and results of
operations have been prepared in conformity with International Financial
Reporting Standards (IFRS).

Information is based on preliminary figures. Final results for fiscal year
2016 will be released on March 10, 2017 (publication of the Annual Report).

This is a translation of the German Quarterly and Full Year Earnings
Release of the Allianz Group. In case of any divergences, the German
original is binding.---------------------------------------------------------------------------

16.02.2017 Dissemination of a Corporate News, transmitted by DGAP - a
service of EQS Group AG.
The issuer is solely responsible for the content of this announcement.

The DGAP Distribution Services include Regulatory Announcements,
Financial/Corporate News and Press Releases.
Archive at www.dgap.de

---------------------------------------------------------------------------

Language: English
Company: Allianz SE
Königinstr. 28
80802 München
Germany
Phone: +49 (0)89 38 00 - 41 24
Fax: +49 (0)89 38 00 - 38 99
E-mail: investor.relations@allianz.com
Internet: www.allianz.com
ISIN: DE0008404005
WKN: 840400
Indices: DAX-30, EURO STOXX 50
Listed: Regulated Market in Berlin, Dusseldorf, Frankfurt (Prime
Standard), Hamburg, Hanover, Munich, Stuttgart; Regulated
Unofficial Market in Tradegate Exchange
End of News DGAP News Service Reported by EQS Group 7 hours ago.

Trump Health Pick Says Maternity Coverage Should Be Optional

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President Donald Trump's pick to lead the government's major health insurance programs says maternity coverage should be optional for patients. Reported by Newsmax 4 hours ago.

We dug into the drug company Martin Shkreli sold out to the Feds, and man is it ugly

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We dug into the drug company Martin Shkreli sold out to the Feds, and man is it ugly· *Medicare spent over $500 million on a drug called Acthar in 2015.*
· *The drug, which has never been tested by the FDA, is the only one in the top-20 for Medicare that isn't considered life-saving.*
· *Now investors are suing MNK because the company said Acthar's success is not dependent on government money.*

Now don't get me wrong, we're no fans of Martin Shkreli.

But we do owe him credit for doing something right. Back in 2014  he complained to the Feds — specifically the Federal Trade Commission (FTC) — about a drug company's anti-competitive behavior.

That company is called Mallinckrodt Pharmaceuticals (MNK), and it was recently forced to pay a $100 million fine for squashing competition to its blockbuster drug, Acthar.

This merits discussion because MNK's problems didn't end with that payment.

MNK recently disclosed that it has joined the ranks of other big drug companies (like Gilead, Valeant and Celgene) being investigated by Justice Department for its patient assistance programs. The pharmaceutical industry spends about $7 billion on these programs a year.

What Washington wants to know is whether or not these programs actually help patients, or just help companies keep drug prices high. Because of that concern, government programs like Medicare and Medicaid already don't accept the help of patient assistance programs. 

Mallinckrodt, like most of the other drugmakers, hasn't said much about what its investigation is actually focused on. 

But by piecing together government data on the sales of Mallinckrodt's blockbuster drug, Acthar, the company's own disclosures, and examining its relationship with the company that manages its patient assistance program, it's not hard to get a sense of all the things the government should be worried about.

This drug — which isn't considered life-saving and is more than 50 years old — is one of the costliest for US government programs, costing tax payers over a half a billion in 2015. 

Also, the main problem Acthar is supposed to treat afflicts infants, but the program that is spending hundreds of millions on it is Medicare Part D — which assists the elderly. Looking at the numbers, you're left with more questions than answers.What is certain, however, is that if this is the way the entire industry is doing business, you should be worried about it too.

** The players club **

Before we dive in here there are a few things you should know about Acthar (or more technically, HP Acthar Gel). 

· Acthar is mostly used as a treatment for infantile spasms. 
· MNK bought Acthar, which is made out of a pig's pituitary glands, back in 2014. Now it's the company's top-selling drug, and could account for up to 40% of the company's revenue in 2017.
· Acthar is typically given for 2-4 weeks and generally requires 2-3 vials at a price of $38,200 per vial.
· It's also one of the top 20 selling drugs for Medicare's Part D program, and it's the only drug in the top 20 that doesn't treat a life-threatening disease.
· In fact, there's debate about whether or not Acthar is effective at treating anything at all. It's been around since the 1950s and was approved before the FDA required the kind of clinical trials it now expects. The drug has 19 different "indications," which means it is used as a treatment for 19 different ailments including Lupus to some dermatological diseases, and multiple sclerosis. 

Because of that last point MNK has become something of a flashpoint in the industry. Wall Street short seller Andrew Left once showed up on CNBC with a $1 million check and said that he would donate it to multiple sclerosis research if MNK would test Acthar.

MNK ignored him. They also ignored multiple requests for comment on this story.

Another important part of Acthar is its relationship with distributor, Express Scripts, which is also being investigated because of patient assistance programs. 

Express Scripts is not a drug company. It is the country's largest pharmacy benefit manager, servicing just under a quarter of health insurance plans (public or private). That means it manages the list of drugs your insurance company (or whoever is paying for your drugs) will pay for. It's a gatekeeper that is supposed to keep costs down. 

But that's not all Express Scripts does. It also has an internal mail-order specialty pharmacy called Accredo Health, which takes a percentage off every drug that it sells, and a business that manages patient assistance programs called United BioSource.

Express Scripts doesn't like to talk about its United BioSource clients. It also doesn't like to talk about which United BioSource clients also have agreements to sell through Accredo Health. We asked the company about that a few months ago and they said all of that was confidential.

What we do know, though, is that Acthar is one of the drugs that has a patient assistance program managed by United BioSource — you can check out the form here — and that it is also sold by Accredo Health. 

We also know that Accredo is paid based on how much Acthar it can get out the door and into the hands of patients, a fact the company denied, and then confirmed, in e-mails with Business Insider. 

United BioSource, Express Scripts says, is paid based on how much staff it needs to figure out who should or should not receive help from its patient assistance program. It doesn't make the rules of those programs and those rules are proprietary to their client, in this case MNK (which would not answer questions about them).

Again, government programs don't allow these programs to pay co-pays for patients because that makes it easier for patients to run up a massive medical tab without thinking about it. Keep that in mind.

** Can I live? **

Now that you know who is running, and helping to sell Acthar, we can bring the government into the mix — because it's doing most of the paying.

MNK sold about $1 billion in Acthar in 2015, and about 65% of that was sold to the government through Medicare and Medicaid.

Acthar was one of the top 20 drugs bought for Medicare Part D patients in 2015 according to the program. Medicare Part D spent about $500 million on the drug, for just 3,104 people.

It is also the only drug of those on the top 20 list that is not considered life-saving. 

Of that $500 million, a little over half goes to patients who are low-income subsidized, so the government is shelling out almost the entire $38,000 price of the drug. Medicare spent an average of $162,371 per Acthar patient in 2015.

Digging into those numbers, if only 3,104 people are taking Acthar, that means Medicare is paying for an average of 23.7 doses a year (obviously not the recommended 2 to 4).

For Medicare Part D patients who are not low income subsidized, though, Acthar costs an average of $8,000 out of pocket a year, the Centers for Medicare and Medicaid Services says.

Sure that's not $38,000 but it is still a pretty high price for seniors to pay. Express Scripts told us that the drug's co-pay for Medicare Part D patients that it manages is $2,000.

So how are under half of them paying for Acthar if they can't use MNK's patient assistance program?

We asked Andrew Miller, of Detroit-based pharmacy benefit manager Meridian, what he thought of this Acthar conundrum. Many of his clients are on government insurance, especially Medicaid. He said that even though Acthar isn't on his formulary (the list of drugs his company will allow insurers to pay for), if a patient needs the drug it can go through an exception process.

Thing is, adults really don't ask for it. The only time he ever needs to make an exception for Acthar, is when it's being used to treat infantile spasms. He's never approved its use for anything adults would need.

"It is rare for any beneficiary regardless of type of insurance (Medicare or commercial) to pay $8,000 out of pocket for most therapies," he said to Business Insider in an e-mail. "Usually when the out of pocket expense is this high there is some sort of copay assistance or manufacturer program option."

So we asked Express Scripts about it, and they were very precise with their answer.

"The Acthar Gel PAP does not pay any OOP [out of pocket] costs for patients with pharmacy coverage," the company told us [emphasis theirs]. 

However, it will give the drug away for free if a patient qualifies for that. And Accredo is also willing to point patients in the direction of a charity that will help them take care of the co-pay as well.

"As a company dedicated to caring for patients with chronic and complex conditions, we support or work with a variety of charitable organizations that assist patients," the company said in an e-mail. "We cannot advise as to whether any of the many charities we have supported offer a patient assistance program, but we state that we do comply with regulatory requirements in making charitable donations."

So somehow, someway, these drugs are getting paid for. Or, more accurately, they're getting into people's hands.

** This game has a cheat **

We saw the dirty version of this game being played at another mail-order pharmacy back in 2015. It was called Philidor, and the pharmacy was secretly owned by a drug company called Valeant Pharmaceuticals until October of 2015. The revelation of Philidor's existence brought the entire company to its knees, and since then its stock price has fallen from a high of $260 to $16.

And here's why: Philidor's game, according to internal documents viewed by Business Insider, was to get as much Valeant product out the door as possible, often paying co-pays for patients. Once the patient had the drug, Philidor would just keep sending refills, also charging the patient's insurer.

Sometimes Philidor would get paid and sometimes it wouldn't, but the more drugs it was able to send out, the more claims it could try to get filled.

That's where the money is — in getting the drug out the door and then doing whatever possible to get the claim filled afterward.

This is why Senators like Elizabeth Warren (D-MA) raged about Valeant's patient assistance programs when company executives were in the hot seat on Capitol Hill last year. Former CEO Michael Pearson claimed that he didn't know how much money using patient assistance programs was netting them, which left Warren incredulous.

Now, if you listen to MNK tell it — and even some people on Wall Street — the company doesn't rely on government sales for its blockbuster drug's survival. In fact, it will tell you that 60% of its sales are to patients with private insurers.

But the numbers don't actually show that. Ever since MNK bought Acthar in 2014, its sales to Medicare Part D especially have exploded, driving growth.

In 2013 the program spent $262.6 million on the drug. In 2014 that jumped to $391.2 million, and then — again — in 2015 the program spent $503 million on the drug.

So investors are upset. Last month shareholders filed a lawsuit against MNK for allegedly lying about its reliance on Medicare and Medicaid for Acthar's revenue. The SEC is also looking into the matter.

But the question here isn't just who pays for Acthar, it's how the drug is paid for. Every tax payer should be wondering why a drug that has never been properly tested is being sent to 3,104 Americans an average of 23 times a year at a cost of over half a billion dollars.

Nobody wants to be a bag holder.

*SEE ALSO: These companies you've never heard of are about to incite another massive drug price outrage*

Join the conversation about this story »

NOW WATCH: The reason millennials became obsessed with payment app Venmo has nothing to do with money Reported by Business Insider 4 hours ago.

CareSource tweaks plans for new Dayton building

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CareSource says its new downtown Dayton office tower is getting adjustments as it ups capacity in another downtown office building. The company is reducing the size of the new CareSource Center City building from seven stories to six. A spokesperson said the office building will downsize from 900 employees to 800. It's unclear how much the square footage will be reduced from the current 250,000-square-foot plan. This comes as the health insurance company plans to purchase the 220 Monument Ave.… Reported by bizjournals 4 hours ago.
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