Health Insurance Medical Loss Ratios

Rebates in 2019

[By staff reporters]

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Hodja Nasreddin and Behavioral Economics [Gains and Losses]

The Difference

[By Anonymous]

One of the most important concepts in behavioral economics is that people react differently to gains and losses. An example from Hodja Nasreddin:

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Hodja Nasreddin

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“One day Nasreddin went to his neighbour and asked to borrow a large cooking pot. The neighbour obliged and Nasreddin promised to bring it back shortly. Weeks passed when the neighbour came by to remind Nasreddin about his pot.

Embarrassed, the hodja went inside and after a short time re-emerged with the pot. On handing it over there was a clanging sound inside upon which the neighbour lifted the lid to reveal a smaller pot inside. “Hodja, what is this?” He exclaimed. “Neighbour, it seems the pot you gave me was expecting and this is her young!” The neighbour gave the hodja a silent look and left with both pots.

Some time later Nasreddin again asked to borrow the pot and the neighbour happily obliged. Again weeks passed and the neighbour came again inquiring about his pot.

“Alas!” Nasreddin said, your dear pot passed on to the afterlife, please accept my condolences.”

“But hodja, how can a metal pot die?” said his neighbour whereupon Nasreddin hodja flew into a rage and yelled:”You had no trouble believing it gave birth but her death strikes you as incredible? Now begone, you rascal!

NOTE: Why backward? http://mullahnasruddin.com/?p=1927

Assessment: Your thoughts are appreciated.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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NEWS: Corona Boosters 2.0

Sub-Variants BA.4 and BA.5

By Staff Reporters

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READ: https://www.msn.com/en-us/health/medical/u-s-rules-out-summer-covid-boosters-to-focus-on-fall-campaign/ar-AA107aqr?cvid=9178f595fefa4fd98b7ec56ac5f90e2e

Re-formulated virus booster shots from Pfizer and Moderna should be on pharmacy shelves by September, a Biden administration official told NBC News.

This means a campaign to release second boosters to a broader swath of the population this summer is being scrapped. These re-tooled shots are intended to provide better protection against the Omicron BA.5 and BA.4 sub-variants, which accounted for more than 90% of new cases in the USA last week.

CITE: https://www.r2library.com/Resource/Title/082610254

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COMMENTS APPRECIATED

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STOP-LOSS Health Insurance?

What is stop-loss insurance AND how does it work?

By Staff Reporters

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A stop-loss health insurance policy covers claims above a health insurance plan’s retained claims. The claims fund of a self-funded employer will pay claims up to the predetermined deductible for each of the company’s covered employees. The role of the stop-loss is to cover all claims above these deductible levels.

CITATION: https://www.r2library.com/Resource/Title/0826102549

According to RoundStone Insurance, aggregate stop-loss insurance is designed to protect an employer who self-funds their employee health plan from higher-than-anticipated payouts for claims. Stop-loss insurance is similar to high-deductible insurance, and the employer remains responsible for claims below the deductible amount.

An individual stop-loss insurance carrier determines the average expected monthly claims per employee / per month PEPM based on the employer’s history. Then, this figure is multiplied by a percentage ranging from 110%-150%. That determined amount is then multiplied by the enrollment on a monthly basis to establish the aggregate deductible.

DHIMA: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

BUSINESS: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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PODCAST: Google Launches Health Insurance Stop-Loss Company

By Eric Bricker MD

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Google Starts Stop Loss Company Called Coefficient

Coefficient Will be a Part of the Verily Healthcare Subsidiary Within Google. Coefficient Will Also Be in Partnership and Partly Owned by the Giant, International Reinsurance Company Swiss Re.

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Subscribe to the Medical Executive-Post

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

DHIMC: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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GENERAL ELECTRIC: Tri-Partite Company Spin-Offs

By Staff Reporters

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ICYMI: After a celebrated 130-year brand history, last fall GE announced plans to create three new, publicly traded companies, building on its heritage of innovation while marking a new beginning.

CITE: https://www.r2library.com/Resource/Title/082610254

And now, these planned companies have names. So meet the three ways GE plans to evolve from building a world that works to creating a future that does, too:

  • GE HealthCare signals continued confidence and trust from clinicians and will bring better outcomes for patients and health systems.
  • GE Vernova represents GE’s portfolio of energy businesses and commitment to leading the global energy transition.
  • GE Aerospace points to a new era of possibility in aerospace and defense for the company’s aviation business.

Visit GE.com to learn more

INVESTING: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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