Category Archives: Insurance

The Long-Term Care Crisis: Why Planning Today Protects Your Future

The Growing Need for Long-Term Care Planning

Most people don’t think about long-term care (LTC) until they or a loved one need it. By then, options are limited, and costs can be overwhelming. With Americans living longer than ever, the need for long-term care is becoming a reality for more families. Yet, most are unprepared.

Consider this:

7 out of 10 people over age 65 will require long-term care at some point.
The average cost of a private room in a nursing home exceeds $100,000 per year, and home health care services can cost thousands per month.
Medicare doesn’t cover most long-term care expenses, leaving many individuals to pay out of pocket or rely on Medicaid, which has strict asset limits.

With these staggering statistics, the question isn’t if you’ll need care—it’s whether you’ve planned for it.

The Real Costs of Long-Term Care

Long-term care isn’t just about nursing homes. It includes:

✓ Home Care – Caregivers assisting with daily activities like bathing, dressing, and meal prep.
✓ Assisted Living – Facilities providing personal care, meals, and social activities.
✓ Nursing Homes – Skilled care for individuals with serious health conditions.
✓ Memory Care – Specialized services for those with dementia or Alzheimer’s.

Who pays? Without insurance, individuals must fund their own care, which can drain retirement savings rapidly. Medicaid covers LTC but only after spending down assets.

Long-Term Care Insurance: Is It Right for You?

Long-term care insurance (LTCI) helps cover these costs and preserves financial security. However, it’s not a one-size-fits-all solution. Here are some key considerations:

Premium Costs – LTCI premiums vary based on age, health, and coverage choices. Buying early (in your 50s or early 60s) locks in lower rates.
Hybrid Policies – These combine life insurance or annuities with LTC benefits, allowing you to use the funds for care or leave a death benefit if unused.
State-Sponsored Programs – Some states (like Washington and California) are exploring mandatory LTC tax programs, making private insurance even more attractive.

Long-Term Care Benefits as an Employee Perk

Why More Employers Are Offering LTCI

With the increasing costs of long-term care and a growing awareness of financial planning, employers—especially small businesses—are adding long-term care insurance to their benefits package.

Competitive Edge – Employers offering LTCI can stand out in today’s competitive job market, helping attract and retain top talent.
Low-Cost, High-Value Benefit – Unlike traditional health insurance, LTCI policies can be offered at little to no direct cost to employers, with employees paying premiums through payroll deductions.
Tax Advantages – Businesses may qualify for tax incentives when offering LTCI to employees.

Small Employers Can Now Compete

Historically, long-term care insurance was seen as a benefit only for large corporations. But today, even small businesses can provide this essential coverage through group LTCI policies or voluntary enrollment plans.

Employers can negotiate better rates and simplified underwriting, making it easier for employees to qualify.
Coverage can be extended to spouses, parents, and even in-laws, making it an attractive family-oriented benefit.
With state-mandated LTC programs on the rise, offering private LTC insurance may help employees avoid state-imposed payroll taxes.

For business owners, providing long-term care insurance isn’t just a perk—it’s a way to protect your employees, their families, and your company’s bottom line.

The PERFECT Long Term Care Solution

So, imagine, if, by implementing ONE strategic product, you could eliminate one of life’s biggest uncertaines, one of life’s biggest What-IF’s?

Enter the PERFECT LTC plan – from CorpStrat. Its pretty amazing. Create a robust pool of care for either individuals, or couples. Can be funded at one-lump sum or over time. Everything about it is guaranteed!

Either one of three things can happen if you act on this:

You get sick and use this plan, and it will PAY A MONTHLY BENEFIT to pay for care to you for as long as you (and your spouse) live.
You quit this plan along the way, because something better comes along, like a new product or strategy is unveiled, and you recapture most (or all) of your outlay. (NOT an EXPENSE – its an ASSET!)
You live a long healthy life and never use or need care, in which case the policy pays a large death benefit to your heirs, tax-free.

No one knows what the future holds, but having a plan ensures that you and your family have choices, dignity, and financial stability when it matters most.

Want to Learn More?

If you’re an individual looking for coverage, or a business owner exploring LTC insurance as an employee benefit, let’s talk!

Out of Tragedy Comes Change: How Public Backlash May Be Reshaping the Health Insurance Industry

Leave a reply

Old general practitioner taking notes at consultation with patient

In the wake of the tragic death of UnitedHealthcare CEO Brian Thompson, a seismic shift is taking place in the healthcare and insurance industries. While the circumstances are deeply regrettable, the event has acted as a catalyst, sparking widespread public discourse and demand for change. This backlash, fueled by years of frustration over denied claims and rising costs, is now opening the door for positive reforms that could reshape the future of healthcare.

Transparency and Accountability: A New Era for Insurers

The intense criticism that followed this tragedy has forced health insurers to face a long-overdue reckoning. Public outcry has highlighted opaque practices around claim denials and coverage decisions, pushing insurers to be more transparent in their operations. In response, many companies are re-evaluating their policies, promising to prioritize patient needs and rebuild trust.

Competitors like Anthem Blue Cross / Blue Shield have already felt the heat, reversing controversial policies, such as limiting anesthesia coverage during surgeries. This swift response underscores the power of consumer advocacy and the importance of accountability in an industry that impacts millions. Plus, it underscores the real complexities involved in managing fraud and abuse, and the consumers expectations of near perfection in a “amazon instant response” expectant world..

Policy Reforms on the Horizon

This public backlash has caught the attention of lawmakers and regulators, many of whom are now prioritizing healthcare reforms aimed at protecting consumers. Proposed changes include tighter regulations on claim denials, improved transparency requirements, and initiatives to curb rising premiums. These reforms, if enacted, could mark a significant step toward creating a more equitable healthcare system.

Elevating Public Awareness

For years, healthcare inequities and challenges have persisted in the shadows, experienced by individuals but rarely discussed on a national scale. Now, personal stories of denied claims and financial struggles are coming to light, creating a collective call for action. This elevated public awareness has empowered consumers to advocate for their rights, putting unprecedented pressure on insurers to improve.

A Spark for Industry Innovation

The backlash is also fueling innovation in the healthcare space. Alternative models, such as Individual Coverage Health Reimbursement Arrangements (ICHRAs), are gaining traction in some states, while MEWA’s (Multiple Employer Welfare Trusts) are breaking the traditional fully insured model and creating non-ACA compliant alternatives for small and medium sized employer. Insurtech startups continue trying to be disruptive, creating consumer-friendly solutions designed to challenge traditional insurance practices.

These trends signal that the industry is ripe for transformation. By focusing on patient-centric care, ethical decision-making, and technological advancements, the healthcare landscape could emerge stronger and more efficient than ever.

Internally, insurance companies are being forced to rethink their culture and leadership priorities. As public trust erodes, the spotlight is on executives to lead with empathy and integrity. This moment could mark the beginning of a new chapter for corporate responsibility in healthcare and across all insurance plans and companies and products.

Conclusion: Turning Crisis into Opportunity

While the events surrounding this backlash are tragic, they have ignited a movement for possible change. By addressing long-standing issues and embracing innovation, the health insurance industry has an opportunity to rebuild trust and create a system that prioritizes fairness, transparency, and patient care. This is not just a moment of reckoning—it’s a chance for transformation. The team at CorpStrat stands ready to guide and lead your team.

What do you think? Could this be the tipping point for real change in the healthcare industry? Share your thoughts in the comments.

Where are all the Health Insurers? Understanding the Lack of Competition in Health Insurance Markets

Leave a reply

health insurance form

The health insurance landscape in the United States has undergone significant changes over the past decade. Since the implementation of the Affordable Care Act (ACA), many expected an influx of competition among health insurers, leading to better choices and lower costs for consumers.

However, the reality has been quite the opposite. The number of companies selling group health insurance has dwindled, raising concerns about the lack of competition in the market.

Dwindling Competition Post-ACA

When the ACA was enacted, one of its goals was to increase competition among insurers to drive down premiums and improve service quality. Initially, there was a surge of new entrants, including co-ops and smaller insurers aiming to capture a share of the market. However, over time, many of these new players exited the market due to financial losses, regulatory challenges, and inability to achieve the necessary scale.

Large insurers have consolidated their positions, often through mergers and acquisitions, leading to a market dominated by a few giants. This consolidation has reduced the number of competitors in many regions, limiting choices for employers and consumers alike.

The Need for Critical Mass Over Providers

Health insurers require a critical mass of enrollees to negotiate effectively with healthcare providers. The larger the insurer’s customer base, the more leverage it has to secure favorable rates from hospitals, doctors, and other providers. This critical mass is essential for:

Negotiating Discounts: Large insurers can demand steeper discounts on medical services due to the volume of patients they bring to providers.
Spreading Risk: A bigger pool of insured individuals allows insurers to spread the risk of high-cost claims, stabilizing premiums.
Administrative Efficiency: Economies of scale in administrative operations reduce overhead costs per enrollee.

Smaller insurers struggle to compete because they lack this negotiating power, making it difficult to offer competitive premiums.

How Contracts Leverage Discounts:

Contracts between insurers and providers are a cornerstone of the healthcare payment system. Insurers negotiate reimbursement rates for services, and these rates directly impact the premiums charged to consumers. Key aspects include:

Fee Schedules: Insurers set predetermined rates for various services, incentivizing providers to agree to lower costs in exchange for patient volume.
Value-Based Contracts: Increasingly, insurers are shifting towards contracts that reward providers for quality outcomes rather than the volume of services, aiming to reduce overall costs.
Network Formation: By creating preferred networks of providers willing to accept lower rates, insurers can steer patients to cost-effective care options.

The ability to secure favorable contracts is heavily influenced by the insurer’s market share, reinforcing the importance of critical mass.

The Role of Transparency in Revitalizing Competition:

Transparency in healthcare pricing and insurer operations can play a significant role in fostering competition without the need for government intervention. Here’s how:

Empowering Consumers: When consumers have clear information about the cost of services and the quality of providers, they can make informed decisions, encouraging insurers to offer better value.
Encouraging New Entrants: Transparency reduces barriers to entry for new insurers by leveling the playing field and exposing opportunities in underserved markets.
Regulating Indirectly: Public disclosure of pricing and contract terms can discourage anti-competitive practices and promote fairer negotiations between insurers and providers.

Several initiatives aim to increase transparency, such as the Transparency in Coverage Rule, which requires insurers to disclose pricing information. While still in the early stages, these efforts have the potential to stimulate competition and reduce costs.

Moving Forward Without Government Intervention:

To address the lack of competition among health insurers, stakeholders can consider the following strategies:

Promoting Transparency Tools: Develop platforms and resources that provide clear pricing and quality information to consumers and employers.
Supporting Small Insurers: Encourage partnerships and alliances among smaller insurers to achieve the necessary scale for competitive contracting.
Innovative Contracting Models: Adopt alternative payment models that focus on value and outcomes, making it feasible for smaller insurers to compete.

By focusing on market-driven solutions that enhance transparency and consumer empowerment, it’s possible to reinvigorate competition in the health insurance industry without additional government mandates.

The consolidation of health insurers and the resulting lack of competition is a complex issue rooted in the dynamics of market share and negotiating power. While the ACA aimed to increase competition, the opposite has occurred in many areas.

However, by leveraging transparency and supporting innovative market solutions, there is potential to revitalize competition, leading to better options and prices for consumers.

Prepare for Success: A Year-End Guide to Estate Planning, Insurance, Financial Organization, & Cleanups

Leave a reply

two colleagues meeting and planning

As the year is quickly coming to a close, it’s the perfect time to reflect on your business and personal financial goals and set the stage for a successful 2025. Year-end planning is crucial not only for assessing the progress you’ve made, but also for taking steps to ensure that next year starts off on the right foot.

A well-thought-out strategy that includes estate planning, insurance reviews, and financial assessments can help you streamline your affairs and create a solid financial foundation for the future.

Estate Planning

One of the first areas to address is your estate planning. If you haven’t already reviewed make sure your will, trust, and other estate documents are up to date. This ensures that your assets will be distributed according to your wishes and that you’ve designated trusted individuals to manage your affairs in the event of an emergency. It’s a good time to meet with your estate planning attorney to review any changes in your family or financial situation and make sure your estate plan reflects your current wishes.

Insurance Coverage

Next, review your insurance coverages. This includes life insurance, health insurance, long-term care, and business policies. Make sure they align with both your personal and business goals. As your business grows, so do your insurance needs. Evaluate whether your current coverage is sufficient for protecting your assets, employees, and loved ones. Year-end is the ideal time to meet with your insurance advisors to ensure that you are well-positioned for the coming year.

Financial Organization

Finally, take a broader view of your business and financial health: Organize all your financial documents, revisit your budget, and assess your investments. Meet with your financial advisor to ensure you’re on track for retirement, and take this time to clean up any loose ends in your business. This could include addressing outstanding debts, reviewing contracts, or reassessing your business operations for efficiency. By doing this, you’ll enter 2025 with a clear vision of your financial goals and a solid plan to achieve them. Set your goals high!!!

In summary, year-end planning is an opportunity to make progress on your 2024 goals while ensuring your affairs are in order. Taking the time to meet with your estate planner, insurance advisor, and financial advisor now will allow you to start the new year with confidence and a renewed focus on growth and stability.

Reach out to us at #CorpStrat for a referral to a professional if you don’t have one.

How much is my drug copay?

Leave a reply

How much is my drug copay

As a consumer or employer navigating the complex world of prescription medications, one of the most frustrating questions we hear is, “How much is my drug copay?”

It seems like it should be a simple answer, but in today’s rapidly changing pharmaceutical and insurance landscape, it’s becoming increasingly complicated. Let us share our experience and what our clients can learn.

Gone are the days when you could confidently walk into your local pharmacy knowing exactly what you’ll pay for a prescription. Now, It’s like a guessing game every time you need to refill a medication.

Why? Because drug prices can vary wildly depending on a multitude of factors:

The specific pharmacy you choose
The insurance plan’s current formulary and tiers
Whether the consumer is using a coupon or discount card
The time of year (Deductible)

New Players Shaking Things Up

Recently, we’ve noticed many new names entering the pharmacy landscape, disrupting Pharmacy Benefit Managers and ultimately bringing transparency to a largely untransparent industry:

Mark Cuban Cost Plus Drug Company

Skeptical at first – a celebrity starting a drug company? But what we are seeing is the single greatest disruption in health care from Mark Cuban: They buy medications directly from manufacturers and add a flat 15% markup plus a small pharmacist fee. They are breaking the model of distribution and delivery of drugs in the USA and bringing transparency in pricing that is leading to total dissolution of the middle men. For some of my prescriptions, it’s actually cheaper than my insurance copay!

GoodRx

This app has been a game-changer for many. The ability to compare prices at different pharmacies in your area and even get discount coupons is powerful There will be times paying cash by using GoodRx is cheaper than going through insurance. Who would have thought? Crazy, and counterintuitive but accurate.

Even with these new options, navigating insurance coverage can still feel like solving a Rubik’s cube blindfolded. Your copays can change based on:

Whether you’ve met your plan or RX deductible
If the drug is considered “preferred” on the plan and what tier it falls into
If you need prior authorization
Whether you are using a specialty pharmacy or where you purchase

What’s a consumer to do?

Here is how end users and employers can guide their employees about managing drug copays:

Always ask questions: Don’t assume your copay is set in stone. Ask your pharmacist if there are cheaper alternatives or available discounts.
Use technology: Apps like Good-Rx can be incredibly helpful in finding the best prices.
Consider alternative sources: Look into options like Mark Cuban’s company, Amazon Pharmacy, Costco, or online pharmacies, but always verify their legitimacy first.
Talk to your doctor: They might be able to prescribe a cheaper alternative or a generic version.
Understand your insurance: It’s a pain but researching through and understanding your plan’s pharmacy benefits and formulary can save you money in the long run.
Don’t be afraid to shop around: Different pharmacies can have vastly different prices for the same medication. And, your health plan may encourage use of a certain pharmacy

The Bottom Line

So, how much is your drug copay? The honest answer is: it depends. The pharmaceutical landscape is changing rapidly, and consumers need to stay informed and proactive. While it can be frustrating to navigate, these changes also bring opportunities for savings. By asking questions, using available tools, and being willing to explore new options, everyone can take control of their prescription costs.