In the News This Month

Insurance Commissioner Works to Get Legal Pot Growers Insured

California Insurance Commissioner Dave Jones recently called on more insurers to enter the marijuana market to help fill gaps in coverage for those whose roles are essential in the cultivation and distribution of the drug. Of course, pot is now legal at the state level but remains illegal at the federal level. Jones organized tours for insurance executives at cannabis businesses and convened meetings between insurance company executives and cannabis business owners to educate the insurance industry about the sophistication, professionalism and risk management of the cannabis industry, according to a California Department of Insurance statement. He noted that he can’t force insurers to accept (and cover) the legal marijuana industry, but that his job was to try to ensure Californians and California industries had access to insurance coverage.

Wipro and Opera Solutions Launch Solution to Detect and Address Fraud and Waste in Health Insurance Claims

Wipro, a global info tech firm, announced the launch of an end-to-end solution to address the issue of fraud, waste, and abuse in healthcare insurance claims in the United States. The initiative is in partnership with Opera Solutions, LLC.

The solution will combine Opera Solutions’ powerful AI and machine learning based Fraud, Waste and Abuse (FWA) detection engine with Wipro’s extensive full-service claim processing capabilities in claims review, which includes the forensic examination of questionable claims, audits, adjustments, negotiations, recovery follow-up and payment posting.

Campaign Calls on Insurers to Ditch Fossil Fuels
Amid the Global Climate Action Summit, a new campaign, Insure Our Future, is calling out the insurance industry for its contribution to climate change. The campaign urges the industry to stop supporting  fossil fuels. Insure Our Future charges that through insuring dangerous dirty energy projects and investing in fossil fuel companies, the insurance industry plays a critical role in driving the use of carbon-intensive energy sources. The U.S.-focused campaign follows significant movement from major European insurers. In the last three years, 17 large international insurers have divested about $30 billion from coal companies, and six have stopped or limited insuring the coal industry, including Allianz, Axa, Zurich and Swiss Re. To date, no major U.S. insurer has yet committed to end their support of fossil fuels.

VSP Offers New Research Insights

VSP Vision Care and market research agency YouGov recently teamed up for some market research. Among the eye opening findings:

  • 8 in 10 people (84 percent) rate vision as the most important sense, and nearly everyone (97 percent) agrees that having healthy eyes is important, but only half of people get annual eye exams.
  • Virtually no one (1 percent each) knows that signs of serious diseases and conditions like high blood pressure, autoimmune disorders, thyroid diseases and certain types of cancers can be detected through an eye exam.
  • 6 in 10 (61 percent) people worry about diabetes impacting their family’s health, but only 4 percent know that eye doctors can detect signs of diabetes through an eye exam.
  • More than two-thirds of parents worry about their children’s eye health more than their own, but only 12 percent of parents know children should receive their first eye exam at six months old.
  • 8 in 10 parents (84 percent) agree that a regular eye exam helps kids do their best in school, but 4 in 10 (41 percent) wait until their child complains about their vision to schedule an eye exam.
  • Twice as many parents worry about their children’s dental problems (15 percent) than their vision issues (7 percent), even though most children lose their baby teeth by age 12 or 13.
  • After learning about the importance of annual eye exams, 9 in 10 (90 percent) survey respondents agree on the importance of annual eye exams.

Self-Insurance Surprises

About 60 percent of people with employer-paid health benefits are covered by self-insured plans. Naturally, you know how a client’s plan is structured, but be aware that many of their employees don’t understand it. One problem is that certain state protections – laws against balance billing and surprise bills, for example—don’t include self insured plans because the plans are regulated by federal rather than state law. To learn more about this and other insurance billing issues, go to Kaiser Health News’ “Bill of the Month” feature on 


A 1980s Invention –LTC Hospitals—Under Fire
A National Bureau of Economic Research study released Monday found that despite being reimbursed at much higher rates than skilled nursing facilities and home healthcare providers, long-term care hospitals don’t produce better outcomes in three important areas: They don’t reduce mortality or length of stay and they leave patients with higher out-of-pocket costs. That’s why a trio of economists says we need to get rid of higher payments to long-term care hospitals. The suggested change should save taxpayers about $4.6 billion per year. More than 70 percent of long-term care hospitals are for-profit, and the report said the largest such providers — Kindred Healthcare and Select Medical — have reported profit margins between 16 percent and 29 percent. Meanwhile, folks in the hospital business says the study is flawed. 

Lower Drug Prices Easy as 1-2-3

Ever wonder how we’re going to get prescription drug costs under control? Well, bloggers for the Commonwealth Fund have it all figured out!  It boils down to a three-step plan based on an international approach:

  1. Other developed countries build market power by aggregating their purchasing to gain negotiating leverage with drug companies
  2. Second, other countries use an authoritative group of experts to systematically assess the value of individual drugs, using the best available information on benefits and expenses.
  3. With value assessments in hand, other countries enter a negotiating process and stand behind it.

Read more at 

Life Insurance Owners Are Optimists – And Other Fun Facts

Ready for some good ol’ life insurance consumer research? This may be counterintuitive, but nonetheless interesting: new research from AIG reveals that 56 percent of life insurance owners are optimists, while only 48 percent of people who don’t have life insurance are optimists. For purposes of the research, optimists were identified by their level of agreement with a battery of statements such as “In uncertain times, I usually expect the best,” “I’m always optimistic about my future,” and “Overall, I expect more good things to happen to me than bad.” Sound like optimists to us. Unfortunately, AIG also found that only 53 percent of U.S. consumers ages 21-64 own life insurance.

Other life insurance fun facts from AIG research:

  • Among consumers who do not participate in a group retirement plan, those who own an individual retirement plan, such as an IRA, are most likely to own life insurance. Of these consumers with individual retirement plans, 64 percent also own life insurance, while only 37 percent of consumers who do not own individual retirement plans own life insurance.
  • Life insurance owners are older and more affluent than non-owners. The median age of life insurance owners is 43, versus 39 for non-owners, and the median annual income of life insurance owners is $88,000, versus $70,000 for non-owners.
  • Also, life insurance owners are more likely than non-owners to work full time (71 percent versus 60 percent), be homeowners (76 percent versus 64 percent) and be married (64 percent versus 53 percent).

What does this mean for you? Younger, less affluent consumers are underserved when it comes to life insurance. Of course.

And In Case You Haven’t Had Enough…

LendEDU also recently released a life insurance survey. Here are a few key findings from that research:

  • Among insurance policy holders, 33 percent indicated that they don’t fully understand their life insurance policy.
  • Amongst policy-holders, 38 percent have a term-life policy, 41 percent have a whole-life, and 20 percent are not sure which policy they have.
  • Amongst respondents that were also repaying student loan debt, 65 percent would rather have their employer provide an equally valuable monthly student loan payment, while 30 percent opted for the equally valuable free life insurance policy provided by their employer