Michael Pennewill

Benefit Professionals…. Wondering why direct contracting is so powerful to help control costs? Take a look at claims data and see what the average paid claim including member cost share is for a cardiac ct calcium score? I bet it’s a heck of a lot higher than $99 and thanks to the team at Green Imaging for helping set this up for me.

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The Individual Coverage Health Reimbursement Arrangement (ICHRA) model for offering health insurance benefits to employees continues to grow in popularity.  ICHRAs are being offered by companies of all shapes and sizes. (Check out www.hracouncil.org for details.)  In many markets across the United States, including Western Pennsylvania where my clients primarily are located, ICHRAs are more prevalent with Applicable Large Employers (ALEs) than they are with smaller ones. I’ve posted previously about the attraction of getting out of the health insurance “risk game” ICHRAs offer to ALEs.  However, in this post, I am highlighting the favorability of ICHRAs based on a dynamic of healthcare utilization that has nothing to do with risk per se. Instead, it has to do with what can be just as important of a determining factor….the gender of those enrolled in coverage. Let’s start with this fact. One’s gender does have an impact on expected healthcare needs. At ages up until about 55 or so, women cost more than men. From that point on, men cost more. However, generally speaking, at age 65 or so the responsibility for health care costs transfers from an employer to Medicare. We regularly perform demographic analyses for our ALE clients. Most of our clients have an average age of their covered employees (and spouses) of 45-49. According to publicly available actuarial data, in this age bracket, females cost 35% more than males. In the 40-44 bracket they are 50% more expensive. Even in the 50-54 bracket, they are still almost 17% higher.  Further evidence supporting cost differentials by gender can be found in a report published in 2023 by Deloitte. It shows “working” women had 18% higher out-of-pocket health care expenses than men EXCLUDING pregnancy-related expenses. It is important to understand these differences because they have a direct impact on either the rates charged to ALEs by their insurer or the projected costs for a self-insured group health plan. Even if a given group performs to the “average”, a group that has more covered females will have higher costs, assuming the same average age, as one with more covered males. In the individual health insurance market rates are NEVER determined based on gender. So, employers who are Applicable Large Employers (ALEs), with a higher ratio of covered females, can escape the rating “bias” against them inherent in the traditional group market.  If you are an ALE in this situation, you should strongly consider having an ICHRA analysis performed. The savings to your organization's health benefits spending could be significant. Transitioning to an ICHRA also unlocks employees' access to individual policies that may be much more affordable than your current group health plan offering, creating a true win-win situation! #ichra

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It's important to stay vigilant when making left-hand turns, which account for 22% of intersection-related crashes. You should always wait to start turning your wheel until it is safe to make your turn. For more tips on making left turns safely, visit Philadelphia Insurance Companies' blog: https://bit.ly/47RjbUr #TEAMPHLY #PHLYProud

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It will be interesting to see the impact of the NJ requirement for higher liability limits for commercial vehicles registered in NJ. #ATG #Acrisure #AcrisureTruckGroup #Limitless #commercialauto #transportation #trucking

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Here is the latest State of the Line report for New Jersey from the pet insurance consulting team at Lewis & Ellis.

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Aging is a natural part of life so we're sharing some tips on #healthy aging and living life to the fullest on the Evolve Insurance Group, LLC. insurance blog!

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Ensuring you have proper insurance in New Hampshire is crucial for protecting your assets and financial well-being. From unpredictable weather events to everyday risks, having the right coverage can safeguard your home, vehicle, and family from unexpected expenses. Proper insurance provides peace of mind, knowing you’re prepared for life’s uncertainties. #NewHampshireInsurance #AssetProtection #FinancialSecurity #InsuranceCoverage #PeaceOfMind Allstate https://lnkd.in/eAETUxBb

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Hello, Loyalty Family! As AEP approaches, we're committed to ensuring brokers are fully prepared to serve their clients the way they deserve. Be sure to watch the entire video featuring the Broker Manager of Anthem Blue Cross Blue Shield in Connecticut, Reginald Meadows for 3 invaluable tips to ensure you're primed for AEP 2025! #AEP #CT #CTINSURANCE #INSURANCE #MARRAMIREZ #MEDICARE #WEKNOWHOWTOTAKECAREOFYOU #FYPAGE

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Original Medicare Part A - Hospitalization costs for 2024 A common misconception I come across with my clients in Suffolk County and Nassau County, Long Island is regarding how Part A of Original Medicare works. There are out-of-pocket expenses that some people are unaware of. For example, there is a deductible for each hospital stay. This is the amount of money you have to pay up front, out-of-pocket, before Medicare starts to cover. Then, after 60 days, you are responsible for a daily copay. A lengthy stay can really add up. Click below to learn about the out-of-pocket expenses for each hospital stay for 2024. https://lnkd.in/emRTDNtv

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Always appreciative of Eastbridge’s dedication to Sup Health, the survey’s & reporting of useful data. I offer the following commentary on some carrier responses: • Flexibility in plan design and choice are the norm, including a standard offering of multiple plans or flexible benefit amounts to match existing benefits. JL: Standard offerings & matching existing benefits= lack of customization. Standard= Carrier generated plans. Matching existing benefits = matching carrier generated plans. Reality is that 92% of companies & brokers implement carrier created & issued plan designs. If we take the time & care to implement medial plans based on the company, medical claims & other factors then why accept a carrier standard plan design for accident, critical illness and hospital indemnity? • Most carriers surveyed say they make frequent product revisions and updates to remain competitive. JL: “Remain competitive”= making revisions to match other carrier revisions. Adding an infectious disease that has a .001% chance of infecting a person in the US is simply to match a line on a broker spreadsheet that another carrier added. • Claims integration, including coordination with medical plans, is a recent key trend carriers expect will continue going forward. JL: I won’t harp on this but someday there will be a legit conversation about improving loss ratios. Unfortunately it will take federal or state government involvement to do so. Why do we offer accident, critical illness and hospital indemnity? The answer is to help people in their time of need. Id venture a guess that these responses are more common: - to pay for enrollment services - to pay for broker services - to reduce cost on a core line of coverage - to leverage _______ (fill in the blank) - to generate revenue To improve this space, individuals, carriers, brokers & enrollment firms all have responsibility. Where to start? - Transparency. Its a shame sup health avoid the transparency rules? VB compensation should not be a difficult conversation. - Consult on VB. If the broker and carrier see Accident, Critical Illness and Hospital Indemnity as products then how do you think HR will see them? - Stewardship. Spend more than 30 minutes annually discussing benefits that CAN make a real impact in a persons life in their time of need. If I’m diagnosed with Cancer, which means more: - the amount of my deductible & OOP max or - a $20,000 tax free benefit I choose $20k to help with my medical expenses AND with my life. Am I venting? Sure but supplemental health should not be a race to zero, a profit center or a product to check the box. These benefits can and do have REAL value if brokers, carriers and employers see them for what they are.

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I enjoy Erie Insurance Group’s insightful blogs that consistently educate our clients with valuable articles. Sharing knowledge is key, and this week's article highlights 8 compelling reasons to secure Life Insurance for your family. Life Insurance need not be a lengthy process. Recently, I efficiently bound coverage for a client in just 10 minutes using Erie Insurance Express Life. The policy was instant issued, providing immediate protection for their loved ones. #instantissued #Erieinsurance #lifematters #protectyourfamily Check out the full article here: https://lnkd.in/enmszian

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A critical illness shouldn't mean a financial crisis. Protect yourself and your family with comprehensive coverage from Premier Employee Benefits of New England, Inc. Invest in peace of mind today for a more secure tomorrow. 🌐 https://lnkd.in/etW6_y3h ☎ (401) 773-3213 #premieremployeebenefits #wellness #employeebenefits #corporatewellness #newengland #workperks #employeewellness #benefitspackage #jobbenefits #hrinsights #tips #educational #worklifebalance #employeeengagement #healthcarebenefits #compensationpackage #employeerecognition #companyculture #flexibleworkperks #careerdevelopment

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Attention NYS employers! The NYS DOL Safety and Loss Prevention Program Code Rule 59 list has been updated. Letters went out to businesses and insurers on the list - October 7th. The deadline to arrange your initial consultation is November 7th and Inspections due no later than December 21st. I have limited availability to take new consultations in Western and Central NY, but you must act fast. I see some familiar names on this list. #nysdol, #safety, #workerscomp, #CR59, #riskmanagement, #losscontrol.

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High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs) are very popular today. Is this type of plan good for you and your family? Read our latest blog post to learn the pros and cons of HDHPs so you can make an educated decision.

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