Meet California’s Insurance Royalty

CAHU recently recognized its members who have been with the association for the long haul. Below is the list of esteemed insurance pros with the longest membership. Take a look: Fear, Katz, Brown, Wood, Word, Dickerson, Thal, Freeman, Warner and so many others. These names are pretty much insurance royalty here in California. We’re very proud to say that many are also regular contributors to Cal Broker. A full list of CAHU members with years of service is here.

Members with 31-42 years of membership



7 Ideas Better Than Publishing Chargemaster List
Hospitals are now required to publish their chargemaster list online, but a new post from The Commonwealth Fund’s Lovisa Gustafsson and Shawn Bishop posits that price transparency without corresponding quality and out-of-pocket-cost data may actually lead to poor health choices and higher costs.

The authors offer these core elements of effective price transparency that Congress, the Trump administration and insurers could consider in creating policies that will better empower patients:

    1. Focus transparency efforts on products and services that are truly shoppable, such as some prescription drugs or diagnostic imaging.
    2. Group health care products and services into units that patients can wrap their heads around, such as episodes of care, procedures, or the annual cost of care.
    3. Combine pricing data with data on quality or health outcomes.
    4. Present standardized data in the same format, in a centralized, convenient location — similar to the Medicare Plan Finder tool, which lets Medicare beneficiaries compare estimated total annual out-of-pocket costs for all Medicare Advantage and Part D plans available to them.
    5. Require price information be made available to physicians and other providers that direct patient care but rarely know the prices or quality of the services they deliver.
    6. Give patients the help they need — whether technology or care navigators or counselors — to weigh quality, cost, and convenience.
    7. Encourage more shared decision-making around treatment options, so that patients’ out-of-pocket costs become part of the equation.


CDI Issues Cease and Desist for NexGen

The California Department of Insurance issued a cease and desist order for NexGen Insurance Services Inc., Riverstone Capital, LLC (dba Riverstone Capital Insurance Services LLC) and its owner/operators Travis O. Bugli, James C. Kelly and Robert M. Clarke. The order follows a joint investigation by CDI and the U.S. Department of Labor, which reportedly found that NexGen and Riverstone have been operating as an unauthorized MEWA. NexGen and Riverstone allegedly failed to pay medical provider claims totaling $24 million. Investigators say NexGen and Riverstone pooled and commingle contributions received from its employer clientele into its own corporate accounts.

Anthem: Health Care and Costs Improve With Integrated Benefits

A new study released by Anthem hints at what is sure to be a growing trend: integrated health care benefits. Anthem studies have determined that when medical, pharmacy, dental, vision and disability benefits are delivered in silos that have little or no interaction between them it too often leaves employees and health care providers with a disconnected view of total body health. By comparison, integrated health care connects benefits data to the employer’s health management program based on member claims and population insights, which provides a fuller picture that delivers better health outcomes and cost efficiencies. According to the latest edition of Anthem’s biennial Integrated Health Care report, more than 71 percent of the 222 employers with 100+ employees surveyed are either actively integrating or considering integrating their medical, pharmacy, dental, vision and/or disability benefits under their employer’s health and wellness programs in the next five years due to the positive impact integration has on their employees. This represents an 11 percent increase from the study conducted in 2016.


Transitions Optical Unveils Updated Healthy Site Working For You Website

Transitions Optical has launched an updated version of its Healthy Site Working For You website.  Check out the savings calculators for both employers and employees, eye care tips, research presentations and much more. By the way, we had a fine time hanging out with brokers and vision folks from VSP and Anthem at the annual Transitions Academy in Florida. Transitions debuted a few products that are really something. Don’t miss Cal Broker’s March issue. We’ll fill you in on the details!


LTC Creeping Into MA?

ThinkAdvisor’s Allison Bell reports that Medicare Advantage plan issuers seem to be taking a quiet, careful approach to adding home- and community-based LTC benefits for 2019.

About 1.5 million of the 2019 enrollees, or 7.5 percent of Medicare Advantage plan enrollees, may have access either to support services in the home or community, or to extra benefits designed to help enrollees cope with the burden of diabetes or other chronic conditions, according to CMS.

One example: In California, units of Anthem Inc. are openly stating that they will use the new flexibility to beef up the benefits offered by some plans. Enrollees in certain Anthem plans will have access to what amounts to LTC benefits provided for a short period of time:

  • Three meals delivered per day for up to 42 days.
  • Four four-hour shifts of in-home assistance with daily living activities, such as laundry.
  • 40 hours of respite care for caregivers per year.
  • One visit per week for adult day care center services, for older adults who need supervision.
  • Health care appointment transportation services.

AALTCI Releases LTC Price Index

The American Association for Long-Term Care Insurance has released the 2019 Long-Term Care Insurance Price index for 55-year-olds. For the first time, the association has included ‘planning’ and ‘savings’ options because consumers considering this protection often cite price as a concern. According to executive director Jesse Slome, a member of the Cal Broker editorial advisory board, too many agents don’t share the planning and saving concepts that would increase their sales and have more consumers buying this important protection. Speaking of Slome, don’t miss this piece he wrote about the largest LTC claims of 2018. AALTCI has been tracking large claims for many years.  In 2018, Slome says:

At each of the seven insurers AALTCI spoke with, the largest open claim was for more than $1 million. At several, the largest open claim has surpassed the $2 million threshold.
Most of the largest claims have been open for at least 11 years.

CMS Can Once Again Terminate MA Plans for Low Ratings

CMS is once again able to terminate Medicare Advantage and Part D drug plans that consistently have poor star ratings. CMS told the providers the news in this memorandum.

U.S. Life Insurance Activity Up in January

U.S. life insurance application activity eased into positive territory in January, with the composite index up 2.1 percent, YOY, according to the MIB Life Index. This is the first sign of YOY growth for the composite Index since July 2018, and on the heels of a -3.5 percent fourth quarter decline.


5 Steps to Defining a Personal Brand

Steven Starks, senior career counselor at University of Phoenix, sent us some tips on defining your personal brand. We thought you might be interested…

  1. Identify Brand Attributes

Everyone has a personal brand, whether they know it or not. One way to discover it is to ask questions that can help uncover personality traits, strengths, interests and values. Consider the moments in life and work where you shine; the interests and passions you daydream about; and the values that are important to you. With these in mind, begin to formulate a personal mission statement for your personal brand. This mission statement will capture the purpose that drives you and the outcomes you strive to achieve. Seek feedback from others and evaluate whether or not the way you perceive your brand aligns with the way others perceive it.

  1. Develop Goals

Clearly developing goals for what you want to accomplish will enable you to know where to invest time and energy to enhance skills, reputation, and professional relationships necessary to build a fruitful career. Don’t limit the scope or size of goals and dreams or prematurely judge whether or not they’re realistic.

  1. Define Audience

All successful brands know their target markets. They research their customers to understand what they want and need, so they can offer products and services that solve their problems, make their lives easier or offer them a pleasant experience. Similarly, you need to know who your target market is. Start with internet research to learn more about the industries you’re targeting and talk to professionals in those fields. Then try volunteering with or otherwise building contacts in those industries.

  1. Tell a Story

One way to establish the central theme of a personal brand is to develop a one- to three-sentence personal brand statement. The goal of this statement is to quickly communicate your skill set and background to your desired audience.

  1. Promote Brand You

Look at your online footprint. Everything you post leaves behind a digital trace of information that is associated with your brand. Delete and refrain from posting any content you don’t want associated with your personal brand. Post what you do want associated!


Webinar “5 Must-Do’s for Selling Your Agency”- Hosted by BetaBenefits
Tuesday, March 5, 10-11 a.m.
RSVP or questions:

LAAHU 5k Charity Run/Walk

March 16, Griffith Park, Los Angeles
Check in 7-8a.m., run starts at 8:15a.m., fun walk starts at 8:30a.m.

All proceeds will be donated to Fit 4 The Cause, a nonprofit that brings exercise and nutrition information to low-income communities. Bring the whole family: $35 for adults, $10 for kids 6-17, under 5 free! More info here. Register here.

BenefitsPRO Broker Expo

April 2-4, 2019, Hyatt Regency, Miami, FL
A leading educational and networking event for employee benefits brokers and agents. Cultivate important relationships and obtain the most practical industry education for positioning your business for sustainable growth. More info here.

CAHU Women’s Leadership Summit

April 3-5, Marriott, Las Vegas
Small group breakouts with introspective discussions focused on self care, relationships, and career success, lead by dynamic speakers, from both within and outside the industry. More info here.

LAAHU Annual Conference

April 17, 2019, Skirball Cultural Center, Los Angeles. Register here.  Exhibitor info here.  Sponsorship info here.

LAAHU’s Annual Conference is the largest in the state and includes updates from D.C., breakout sessions for IFP, small group, large group, medicare and more!

IICF Casino Night

May 16, 6-10p.m. San Francisco Register here.

IICF Women in Insurance Global Conference- save the date!

June 12-14, 2019, New York City


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