When sales of Affordable Care Act plans begin Nov. 1, a growing number of consumers around the country will be able to get coverage for 2018 without paying any monthly premium.
Reported by Wall Street Journal 16 hours ago.
Free Health Insurance to Reach More People in 2018
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CVS is plotting a $66 billion takeover — and it has a lot to do with fending off Amazon (AET, CVS, AMZN)
· *CVS Health's potential** deal to buy Aetna has a lot to do with Amazon, and it illustrates just how serious a threat the tech giant is to traditional healthcare companies.*· *The move would give CVS control over more of the chain between a drugmaker and a patient, possibly bolstering profits. *
· *But it remains to be seen if a deal like this can protect healthcare companies from being "Amazon'd."*
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Amazon's notorious for stepping into new businesses and crushing the competition with low price, fast delivery, and its massive network of loyal shoppers. When Amazon bought the grocer Whole Foods, shares of other supermarket chains plunged, out of fear they'd be Amazon'd.
Now, the e-commerce giant has its eye on the pharmacy business, and one of the biggest drug retailers — CVS Health — is trying to stay one step ahead.
CVS, which has more than 9,700 stores nationwide, is reportedly in talks to buy health insurer Aetna in a $60 billion plus deal that would create a new type of company that includes a health insurer, a retail pharmacy, and a company that negotiates prescription drug prices with drugmakers. That CVS had offered to buy Aetna was reported by The Wall Street Journal, which also reported on Thursday, that the deal has a lot to do with Amazon.
It's no coincidence. Speculation that Amazon might be getting into the pharmacy business has been rampant for months — and it came to a head, coincidentally, on Thursday when the St. Louis Post-Dispatch reported that Amazon has been approved for wholesale pharmacy licenses for at least 12 states.
There are two ways in which a tie-up with an insurer like Aetna — which covers 46.7 million Americans — could help protect CVS from this.
· It would give CVS control over more of the chain between a drugmaker and a patient, possibly bolstering profits by letting it keep more of a cut of each sale.
· Directing Aetna clients into CVS pharmacies for their medicines would keep the foot traffic coming into its retail locations, and let it keep selling high-margin groceries to those shoppers.
*Fending off Amazon*
Should Aetna merge with CVS, it would bring the largest pharmacy, one of the largest pharmacy benefits managers, and the third largest insurer all under one roof. Each one of those pieces is part of the complicated process of paying for prescriptions drugs.
Essentially, CVS would own every step of the process with the exception of drug wholesalers, which are in charge of shipping drugs to pharmacies and hospitals, and the pharmaceutical companies that actually make the drugs. That would keep much of the money changing hands within the same company.
Here's a chart explaining how a drug travels from pharmaceutical manufacturer to a patient, and who takes a cut in the process. It's a complicated web of payments and rebates, but the simplified outcome of a deal that puts pharmacy, insurer, and PBM in one company is that the combined business walks away with more of a drug's sale price in the end.
With the Aetna deal, CVS would control everything that happens once a wholesaler has handed off the drug.Already, CVS and Aetna are heavily linked in the pharmacy area. In 2010, Aetna entered into a 12-year contract with CVS Caremark, CVS's PBM arm to manage its prescription drug spending.
PBMs and insurers also have a lot of power over what prescription drugs get paid after a doctor prescribes them. For example, it can choose to only cover the generic form of a medication or a lower cost competitor — and those decisions certainly impact the insurer.
CVS wouldn't be alone in controlling both the insurer and PBM part of paying for prescriptions. UnitedHealthcare, for example, owns the PBM OptumRx, while Anthem, which owns a variety of Blue Cross Blue Shield health insurance firms, will be launching its own PBM called IngenioRx.
But CVS would be unique in owning three parts of the chain.*Foot traffic*
While most of what we know about Amazon's potential interest in getting into the pharmacy business is speculation, it's clear that if patients could get their medications shipped directly from Amazon, that could hurt the retail pharmacy business.
Robert Handfield, a professor of supply-chain management at North Carolina State University, told Business Insider that one area where this deal would help CVS out is by directing Aetna members to CVS's pharmacy locations. The actual amount of money prescriptions bring into pharmacies isn't all that much, Handfield said, it's what else you buy while you're at the pharmacy — snacks, drinks, beauty products, etc. — that makes pharmacies a booming business.
Say that prescription portion went online, it would be much harder for retail pharmacies to compete with convenience stores, grocery stores and anyone else selling candy bars and deodorant. But say you're an Aetna member, the preferred way to get your prescription might be by going to a CVS pharmacy, bringing foot traffic that might not come organically.
It remains to be seen whether Amazon does get into the pharmacy business, and if it does, if this kind of deal has what it takes to make healthcare companies Amazon-proof.
*SEE ALSO: The Wall Street analysts who called CVS's huge potential deal last month explain why it could 'realign' the entire industry*
Join the conversation about this story »
NOW WATCH: How Bill Gates and Warren Buffett are changing the world like no other humans in history Reported by Business Insider 5 hours ago.
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Blow for private patients as Bupa pulls out of Belfast Trust hospitals
One of the UK's biggest private health insurance companies has pulled out of Belfast Trust hospitals, it can be revealed today.
Reported by Belfast Telegraph 14 hours ago.
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With Federal Funds Cut, Others Must Lead Health Insurance Sign-Up Efforts
Since the Trump administration slashed outreach funds and shortened the enrollment period to sign up for Affordable Care Act plans, local groups struggle to get the word out to Latinos and others.
Reported by NPR 8 hours ago.
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Maryland senator wants special session on health insurance
BALTIMORE (AP) — A Maryland state senator is calling for a special session of the General Assembly in light of President Donald Trump’s decision not to fund cost-sharing subsidy payments to insurers. Democratic Sen. Jim Brochin says the state should pass a law agreeing to pay for the subsidies for individual health insurance plans that […]
Reported by Seattle Times 3 hours ago.
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Md. small business owners: 'Our family cannot afford another rate increase'
Maryland's health insurance premium rates for ACA individual marketplace plans have increased by double digit percentages each of the past four years.
Reported by bizjournals 3 hours ago.
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Trump's plan to end health care subsidy could yield unintended consequence
Policy experts suggest that shutting down a major 'Obamacare' health insurance subsidy could mean free basic coverage would be available to more people.
Reported by Christian Science Monitor 19 hours ago.
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Open enrollment: A cheaper plan isn't always the best choice
It's that time of year when you review your employer-sponsored benefits. One of the most significant decisions you'll make during open enrollment is about your health insurance.
Reported by Newsday 9 hours ago.
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Trump: ‘Dems Own’ Health Insurance Premium Increases, Obamacare Will Be Repealed and Replaced
The president is up and tweeting.
Reported by Mediaite 7 hours ago.
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It will be a tale of 2 countries as open enrollment begins
ST. PAUL, Minn. (AP) — The Trump administration’s efforts to undermine the Affordable Care Act have health care advocates and insurers concerned that the open enrollment period will be one of chaos and confusion. That’s not true everywhere. A dozen states operate their own health insurance marketplaces, maintaining control over advertising and the help they […]
Reported by Seattle Times 5 hours ago.
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What Consumers Should Know When Purchasing Health Insurance
It's time to sign up for a health plan if you purchase insurance on the Affordable Care Act exchanges. NPR's Michel Martin speaks with Kaiser Health News Washington correspondent Julie Rovner.
Reported by NPR 22 hours ago.
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Kasich-backed Medicaid expansion faces powerful Ohio panel
COLUMBUS, Ohio (AP) — A Medicaid expansion championed by Ohio Gov. John Kasich (KAY’-sik) over many fellow Republicans in Columbus and Washington is hanging in the balance again. A powerful legislative spending panel must decide Monday whether to re-authorize spending for the expansion, which now provides health insurance coverage for more than 700,000 low-income adults. […]
Reported by Seattle Times 17 hours ago.
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Vermont Health Connect open enrollment starts Wednesday
MONTPELIER, Vt. (AP) — Open enrollment starts Wednesday for Vermonters who want to sign up for a health insurance plan for next year through the state’s online exchange or existing subscribers who want to change to a different plan. The annual enrollment period runs from Wednesday to Dec. 15. Officials tell Vermont Public Radio that […]
Reported by Seattle Times 17 hours ago.
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Central Americans fear Trump may ax immigration program
LOS ANGELES (AP) — Irma Acosta has spent the last two decades enrolled in an immigration program that has helped her get a work permit, put three children through school in her native Honduras and obtain health insurance to cover her cancer treatment. Now, the 51-year-old hotel housekeeper from Los Angeles fears it could all […]
Reported by Seattle Times 13 hours ago.
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United States: Interim Final Rules Expand Contraceptive Coverage Exemption Based on Religious/Moral Beliefs - Reed Smith
The Trump Administration has issued interim final rules to make it easier for employers and health insurance plans to qualify for an exemption from ACA rules mandating coverage of contraceptive services without cost sharing on the basis of religious or moral objections.
Reported by Mondaq 9 hours ago.
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Pivot Health Expands Alternative Plan Solutions For Health Insurance Open Enrollment Season
Adds zero deductible benefit plans to its portfolio of short term health insurance and supplemental plans for consumers looking for more affordable health care options
Scottsdale, Ariz. (PRWEB) October 30, 2017
Alternative health insurance leader Pivot Health recently announced the release of its new zero deductible health insurance plans, rounding out its product offering of health insurance options. The zero deductible plan features cash benefits for doctor office visits, hospital stays, lab work, surgery and more without the costs associated with deductible and coinsurance plans.
“This year’s open enrollment period will be very different than past years because many consumers have fewer affordable choices,” said Jeff Smedsrud, Chief Executive Officer of Pivot Health. “Five years after the Affordable Care Act (ACA) marketplaces launched, for many consumers who do not receive subsidies to pay their premiums, the marketplace plans are simply unaffordable. This is why zero deductible plans can be a great solution for families that need cash to pay for everyday doctor office visits or unexpected accidents instead of being responsible for thousands of dollars of medical bills their traditional ACA medical plan won’t pay.”
In addition to zero deductible benefit plans, Pivot Health offers direct-to-consumer and agent-assisted short term health insurance, plus plans to help supplement insurance gaps when accidents and sudden illnesses occur. Short term medical plans recently received a victory with President Trump’s executive order on October 12, encouraging expansion of the availability of short term products, with longer coverage periods and renewals. These new rules will be a help to some individuals and families looking to purchase a more affordable health insurance option. Short term health insurance plans often exclude pre-existing medical conditions.
“Now more than ever, consumers have expanded choices because our plans help them take control over how much they spend on health plan costs,” said Smedsrud. “Come November 1 when open enrollment begins, the American health care consumer will be able to sign up for an ACA plan or get more affordable, zero deductible health benefits. The choice will be theirs to make. But at least they will have a choice.”
Smedsrud urged consumers whose income makes them eligible for marketplace subsidies to consider them their first choice, but to complement that choice with a Pivot Health plan that fills costs not covered by high deductibles. Only plans sold in the ACA marketplaces are eligible for premium subsidies.
About Pivot Health
Launched in 2016, Pivot Health is an insurance product development, management and marketing company led by an experienced team of health insurance professionals that has managed more than $7 billion of insurance premium. The company has proprietary products and dedicated relationships with many national carriers. The founders of Pivot Health have led previous firms that were acquired by NYSE companies or that rank in the Top 100 for fastest growing private companies in the U.S. Jeff Smedsrud is a co-founder of insurance shopping site HealthCare.com Reported by PRWeb 9 hours ago.
Scottsdale, Ariz. (PRWEB) October 30, 2017
Alternative health insurance leader Pivot Health recently announced the release of its new zero deductible health insurance plans, rounding out its product offering of health insurance options. The zero deductible plan features cash benefits for doctor office visits, hospital stays, lab work, surgery and more without the costs associated with deductible and coinsurance plans.
“This year’s open enrollment period will be very different than past years because many consumers have fewer affordable choices,” said Jeff Smedsrud, Chief Executive Officer of Pivot Health. “Five years after the Affordable Care Act (ACA) marketplaces launched, for many consumers who do not receive subsidies to pay their premiums, the marketplace plans are simply unaffordable. This is why zero deductible plans can be a great solution for families that need cash to pay for everyday doctor office visits or unexpected accidents instead of being responsible for thousands of dollars of medical bills their traditional ACA medical plan won’t pay.”
In addition to zero deductible benefit plans, Pivot Health offers direct-to-consumer and agent-assisted short term health insurance, plus plans to help supplement insurance gaps when accidents and sudden illnesses occur. Short term medical plans recently received a victory with President Trump’s executive order on October 12, encouraging expansion of the availability of short term products, with longer coverage periods and renewals. These new rules will be a help to some individuals and families looking to purchase a more affordable health insurance option. Short term health insurance plans often exclude pre-existing medical conditions.
“Now more than ever, consumers have expanded choices because our plans help them take control over how much they spend on health plan costs,” said Smedsrud. “Come November 1 when open enrollment begins, the American health care consumer will be able to sign up for an ACA plan or get more affordable, zero deductible health benefits. The choice will be theirs to make. But at least they will have a choice.”
Smedsrud urged consumers whose income makes them eligible for marketplace subsidies to consider them their first choice, but to complement that choice with a Pivot Health plan that fills costs not covered by high deductibles. Only plans sold in the ACA marketplaces are eligible for premium subsidies.
About Pivot Health
Launched in 2016, Pivot Health is an insurance product development, management and marketing company led by an experienced team of health insurance professionals that has managed more than $7 billion of insurance premium. The company has proprietary products and dedicated relationships with many national carriers. The founders of Pivot Health have led previous firms that were acquired by NYSE companies or that rank in the Top 100 for fastest growing private companies in the U.S. Jeff Smedsrud is a co-founder of insurance shopping site HealthCare.com Reported by PRWeb 9 hours ago.
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Lauren’s List: Give Your Health Insurance A Check Up
Maybe you've seen the notifications in your office - it's that time of year for open enrollment.
Reported by cbs4.com 8 hours ago.
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Pacific Resources Acquires Universal Benefits Consulting LLC
Healthcare industry leader in employment benefits advisory joins the Pacific Resources team
BOSTON (PRWEB) October 30, 2017
Pacific Resources Benefit Advisors, LLC, a subsidiary of Brown & Brown, Inc. and a leading non-medical employee benefits advisory firm, has acquired Universal Benefit Solutions, L.L.C. (“UBS”). UBS represents large clients in the placement of ancillary employee benefits products. Their primary focus is the healthcare sector.
“Joining the Pacific Resources family gives us the resources and capital to continue to drive rapid business growth while providing our clients with exceptional service and ROI, said Brandon Brickweg, Founder of Universal Benefits Solutions. ”The cultural alignment of our organizations made a partnership with Pacific Resources a natural alliance.”
“UBS is an employment benefits advisory leader in the healthcare industry,” said Paul Barden, CEO of Pacific Resources. “Partnering with a market sector leader to elevate and expand our service and subject matter expertise, is critical to reaching our strategic growth objectives. Finding a team like Brandon’s that is culturally synergistic with ours, made this the logical next step for our business.”
About Pacific Resources
Pacific Resources, a wholly owned subsidiary of Brown & Brown, Inc., is a leading independent employee benefits advisory firm that works with Fortune-ranked and other large companies. For four decades, Pacific Resources' evidence-based insights have shaped innovative employee benefit solutions, helping companies get the most value from their benefit plans, and positively impacting the lives of millions of employees and their families. For more information, visit us online at http://www.pacresbenefits.com.
About Brown & Brown, Inc.
Brown & Brown, Inc., through its subsidiaries, offers a broad range of insurance products and related services. Additionally, certain Brown & Brown subsidiaries offer a variety of risk management, third-party administration, and other services. Serving business, public entity, individual, trade and professional association clients nationwide, Brown & Brown is ranked by Business Insurance magazine as the United States’ sixth largest independent insurance intermediary. Brown & Brown’s Web address is http://www.bbinsurance.com.
About Universal Benefit Solutions, LLC
Universal Benefit Solutions specializes in ancillary benefit programs. Most intermediaries are required to spend most of their efforts on health insurance products. In doing so they are neglecting the needs of their customers concerning the ancillary benefit programs. Universal Benefit Solutions has no interest in health insurance. Ancillary benefits are of course an integral part of any benefits program. These programs deserve the full attention and dedicated resources necessary to establish the greatest possible benefits for your employees at the best negotiated price for your company. The correct benefits package not only outlines your company's employee benefits direction, but, just as importantly, increases productivity and morale in the work force. Reported by PRWeb 7 hours ago.
BOSTON (PRWEB) October 30, 2017
Pacific Resources Benefit Advisors, LLC, a subsidiary of Brown & Brown, Inc. and a leading non-medical employee benefits advisory firm, has acquired Universal Benefit Solutions, L.L.C. (“UBS”). UBS represents large clients in the placement of ancillary employee benefits products. Their primary focus is the healthcare sector.
“Joining the Pacific Resources family gives us the resources and capital to continue to drive rapid business growth while providing our clients with exceptional service and ROI, said Brandon Brickweg, Founder of Universal Benefits Solutions. ”The cultural alignment of our organizations made a partnership with Pacific Resources a natural alliance.”
“UBS is an employment benefits advisory leader in the healthcare industry,” said Paul Barden, CEO of Pacific Resources. “Partnering with a market sector leader to elevate and expand our service and subject matter expertise, is critical to reaching our strategic growth objectives. Finding a team like Brandon’s that is culturally synergistic with ours, made this the logical next step for our business.”
About Pacific Resources
Pacific Resources, a wholly owned subsidiary of Brown & Brown, Inc., is a leading independent employee benefits advisory firm that works with Fortune-ranked and other large companies. For four decades, Pacific Resources' evidence-based insights have shaped innovative employee benefit solutions, helping companies get the most value from their benefit plans, and positively impacting the lives of millions of employees and their families. For more information, visit us online at http://www.pacresbenefits.com.
About Brown & Brown, Inc.
Brown & Brown, Inc., through its subsidiaries, offers a broad range of insurance products and related services. Additionally, certain Brown & Brown subsidiaries offer a variety of risk management, third-party administration, and other services. Serving business, public entity, individual, trade and professional association clients nationwide, Brown & Brown is ranked by Business Insurance magazine as the United States’ sixth largest independent insurance intermediary. Brown & Brown’s Web address is http://www.bbinsurance.com.
About Universal Benefit Solutions, LLC
Universal Benefit Solutions specializes in ancillary benefit programs. Most intermediaries are required to spend most of their efforts on health insurance products. In doing so they are neglecting the needs of their customers concerning the ancillary benefit programs. Universal Benefit Solutions has no interest in health insurance. Ancillary benefits are of course an integral part of any benefits program. These programs deserve the full attention and dedicated resources necessary to establish the greatest possible benefits for your employees at the best negotiated price for your company. The correct benefits package not only outlines your company's employee benefits direction, but, just as importantly, increases productivity and morale in the work force. Reported by PRWeb 7 hours ago.
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5 Things To Know When Shopping For Health Insurance This Year
Open enrollment on the exchanges for health insurance created by the Affordable Care Act will be different this time around. Here are some tips on how to make the most of it.
Reported by NPR 5 hours ago.
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How to get tax credits — and other things you need to know for health exchange enrollment this week
Marylanders can start signing up for insurance through the Maryland Health Benefit Exchange on Wednesday as the 2018 open enrollment season for Affordable Care Act health plans kicks off. Despite ongoing debates at the federal level about whether the ACA is the best policy for the U.S. health industry, for now, it is still the law of the land. According to the law, all Americans must purchase some kind of health insurance. And for those who need to enroll this year or change their insurance plans,…
Reported by bizjournals 2 hours ago.
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