Health Insurance

Making The Healthcare System Fair Again!

Matt Ungs, the Founder of Patient Fairness, a one-of-a-kind platform that is dedicated to helping people lower or eliminate unfair medical bills here in America joins eHealth Radio and the Health News and Healthcare Channels.
Listen to interview with host Eric Michaels & guest Matt Ungs discuss the following:
How did you come up with this concept to help people with their medical bills?
What is the biggest over payment or issue you are seeing today?
What changes with the current healthcare system in America would you like to see changed?
What types of clients do you take on and how can they successfully use your platform?
What advice do you have for anyone going to see a doctor or using an urgent care or any other provider today?
Matt Ungs founded Patient Fairness after a nearly three-decades career at health plans negotiating with hospitals, physicians and other medical providers to participate in insurance networks. Over the years, he observed that medical providers and health insurers were thriving as medical prices and insurance premiums soared. Patients and the public suffer because they fund provider and insurer prosperity through higher medical bills, employer benefit costs and direct insurance premiums. Worse yet, medical providers and health insurers use patients as collateral as they fight over pieces of the prosperity pie, while the patients are stuck in the middle with surprise medical bills and unaffordable charges.
For more on Matt Ungs click here.
Website: https://www.patientfairness.com
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A Revolution Has Begun in America’s Health Care Coverage

 
 
Seasoned author and finance expert, Murray Sabrin, PhD, emeritus professor of finance at Ramapo College of New Jersey joins eHealth Radio and the Health Care and Health News Channels. His new is book, The Finance of Health Care: Wellness and Innovative Approaches to Employee Medical Insurance.
Listen to interview with host Eric Michaels and guest Dr. Murray Sabrin discuss the following:
How healthy are the American people?
How can wellness programs improve the health of employees?
Why do most workers get health insurance through their employers?
Why is traditional health insurance so expensive?
What are the alternatives?
Lastly if you would, explain the "silent revolution" that is going on in healthcare.
Seasoned author and finance expert, Murray Sabrin, PhD, is emeritus professor of finance, Ramapo College of New Jersey. Dr. Sabrin is considered a “public intellectual” for writing about the economy in scholarly and popular publications. His new book, The Finance of Health Care: Wellness and Innovative Approaches to Employee Medical Insurance (Business Expert Press, Oct. 24, 2022), provides business decision makers with the information they need to match the optimal health care plan with the culture of their workforce.
Learn more at murraysabrin.com, and follow his commentary twice a week at murraysabrin.substack.com.
 

Annual Enrollment – Choosing the Right Health Coverage Option

 
Christine Cooper, the CEO of aequum LLC and the Co-Managing Member of Koehler Fitzgerald LLC, a law firm with a national practice along with Jack Towarnicky an ERISA/Employee Benefits compliance and planning attorney, having over forty years of experience in human resources and plan sponsor leadership roles again joins eHealth Radio and the Healthcare and Legal Channels.
Listen to interview with host Eric Michaels and guests Christine Cooper & Jack Towarnicky discuss the following:
Painful mistakes you and/or your employer should avoid at annual enrollment.
Eric: Number 10 – Christine, what’s number 10?
Christine: Number 10 is an employer mistake. It is the employer who fails to offer workers a choice of coverage. Regardless of the size of the employer, the employer should anticipate a diversity of medical coverage needs, today, AND tomorrow! At a minimum, the employer should offer at least two choices, typical would be a PPO and Health Savings Account capable options.
Eric: Who has number 9? Jack?
Jack: Number 9 is also an employer mistake. It is the decision to use a passive process. Passive means that the worker’s existing coverage will continue unless they take action to review the options and make choices. The annual enrollment process should prompt individuals to make affirmative elections – even if it is the same choices, year after year.
Eric: Interesting, so what is Number 8?
Jack: Number 8 is another employer mistake. It is the failure to adjust the coverage comparison so the differences, especially the differences in provider networks and costs are apparent, obvious. For example, where a HSA-capable coverage option is offered, the employer often fails to adjust the deductible for the other choice, typically the PPO, so that the deductible for the PPO applies in the same way. Bottom line, once you have a good idea about your expected utilization, if you must spend more than 5 minutes looking at a side-by-side comparison, that means that the differences aren’t obvious, or that the comparison has too much detail.
Eric: OK, three strikes and the employer are out. So, our audience now knows that the employer should offer a choice of coverage, and at least one of the options should allow the worker to save in a Health Savings Account. The employer should have an active enrollment process, not a passive process, where workers must make affirmative elections of coverage. And the side-by-side comparison should be clean and clear enough so that a worker who knows what they expect to spend on medical can make a decision in less than 5 minutes. OK. So now we have some ideas about what you might ask your employer.
Eric: What’s next? What’s Lucky Number 7?
Christine: More like unlucky #7. Number seven is bias. We let bias affect our decisions. We tend to make decisions by relying on heuristics, or rules of thumb. One example is where people might think Expensive is Better … that the coverage with the smallest deductible or the highest contribution must be the better choice – even though I don’t anticipate any significant medical expenses.
Eric: With six you get egg roll! You could look it up. What is number six?
Jack: Over insurance, you paid too much! Or, as one insurance company motto says, only pay for what you need. Over insurance can result by focusing too much on monthly or per payday costs (what is affordable) versus an estimate of all costs for an entire year. Bias also causes workers to overestimate the likelihood of easy to imagine outcomes, or recent events, what some call the availability heuristic – for example, a coworker who suffered an illness or injury. People sometimes fixate on “what if?” As in what if I need surgery?
Eric: What is five?
Christine: Uncertainty. Uncertainty tends to result in opportunity losses. There is a lot of uncertainty in predicting medical utilization. But, for almost everyone, medical spend increases with age. So, the time to save is now, because our out-of-pocket expenses are likely to increase in the future. And, when it comes to saving for future medical expense, the best option is the Health Savings Account. Why the HSA? Well, it saves on taxes. Often, there is an employer contribution. And consider this. Most of us are likely to make it to retirement age, when, if we are lucky enough to have avoided medical costs, we can spend HSA dollars the same way we spend money from a 401k or an Individual Retirement Account. Actually, saving in a HSA is often better than saving in a 401k.
Eric: Saving in a HSA is better than saving in a 401k? Where can you find more info?
Christine: Contact us at aequumhealth.com, or specifically, contact Jack with your questions about Health Savings Accounts. Or, if your employer doesn’t offer a Health Savings Account capable plan, have your employer reach out to Jack. Jack is one of America’s foremost experts when it comes to the Health Savings Account, its features and value. He’s been participating in a HSA over 17 years, since 2005. You can find his email address by visiting us at www.aequumhealth.com. 
Eric: OK, we’re down to the last four. Number 4?
Jack: It’s another employer mistake – choice blindness, or choice overload. Studies show that three choices are often one too many – especially for something as complex as medical coverage.
Eric: Number 3?
Christine: It is another employer mistake, this time in marketing or communications. Too many times, employers focus communications on the deductible. Some even name the options that way – for example, the $500 plan. That results in something economists call an “anchoring bias”. It draws an inordinate amount of attention to the size of the deductible. During annual enrollment, in your decision-making, you should compare the difference in deductibles between options, the difference in contributions between options and the difference in total costs based on your expected utilization.
Eric: We are down to the Number 2 mistake.
Jack: Myopia. One big mistake we all make is limiting our focus to today, next week, next month, next year. But we all expect to live beyond 2023. So, our coverage decisions should include today and tomorrow, specifically saving, improving our household’s financial resilience. Accumulating savings in 2023 ensures you are better prepared for future annual enrollment decision-making.
Eric: And the Number 1 mistake people make when it comes to annual enrollment?
Christine: Inertia. People are inert. Most don’t spend more than 30 minutes on benefits decision-making each year. Some skip annual enrollments altogether. I mean, nothing has changed in your life, or your household, or in the coverage marketplace, or in your employment over the past 3 years, right? Remember to ask other adults in your household for their input. If you are enrolled in the same health coverage today that you were before the pandemic, you should at least reconsider any available alternatives … just in case they changed. Also, if you are enrolled in a Health Savings Account, it is a good time to update your rate of contributions … but remember, unlike other accounts, you can prospectively change your HSA contribution rate, any month during the year. Keeping the same choice, year after year after year is a form of status quo bias. How would you know if it is still the right choice…unless you give it a new, fresh look. Don’t know where to start, ask for help.
We’ll put a summary of this discussion on our website www.aequumhealth.com – so you can refer to it for this year’s annual enrollment (and future years as well). Start today. Ask your employer for the dates of the annual enrolment, and what coverage option will be offered in 2023. Have them contact Jack and encourage them to offer a Health Savings Account capable option. Start putting together your estimate what you and your household members will spend on medical in 2023.
And, when annual enrollment comes, don’t forget to take time to review your choices and make an affirmative decision, election for 2023.
Christine M. Cooper, CEO and Member, aequum LLC
Christine M. Cooper is the CEO and Member, of aequum LLC. A patent lawyer recruited to Koehler Fitzgerald LLC in 2016 because of her large law firm experience and IT skills, Christine was quickly elevated to a member of Koehler Fitzgerald LLC and leads the health care practice. Christine is the CEO of aequum and is dedicated to assisting and defending plans and patients.
Jack Towarnicky Member, aequum LLC
As an ERISA/Employee Benefits compliance and planning attorney, Jack has over forty years of experience in human resources and plan sponsor leadership roles. This includes twenty-five years as the leader of a Fortune 100 corporation’s benefits function. While serving in those roles, Jack and his team won a multitude of individual, team and corporate recognitions. In 2020 Jack joined aequum and provides plan drafting and compliance services to employers and plan sponsors.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 
 

Advanced EOB: How it works for healthcare consumers and employer-sponsored health plan members

 
 
Christine Cooper, the CEO of aequum LLC and the Co-Managing Member of Koehler Fitzgerald LLC, a law firm with a national practice. Christine leads the firm’s health care practice and is dedicated to assisting and defending plans and patients again joins ehealth Radio and the Healthcare and Health News Channels.
Listen to interview with host Eric Michaels and guest Christine Cooper discuss the following:
What is the Explanation of Benefits or “EOB”? What role does it plan in your employer-sponsored health plan?
What is an “Advanced” Explanation of Benefits (EOB), and how does it work for healthcare consumers and employer-sponsored health plan members?
How can health plan members ask for an Advanced EOB?
How does a member evaluate an Advanced EOB when received? How can they request another quote for the same procedure from a different provider?
How can members work with its plan administrator for guidance and to identify a reasonable price for procedure?
Christine M. Cooper is the CEO and Member, of aequum LLC. A patent lawyer recruited to Koehler Fitzgerald LLC in 2016 because of her large law firm experience and IT skills, Christine was quickly elevated to a member of Koehler Fitzgerald LLC and leads the health care practice. Christine is the CEO of aequum and is dedicated to assisting and defending plans and patients.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 

The Recessionary Impact on Employer-Sponsored Health Coverage: Will it be Different this Time? Who Pays? How Much?

 
 
Jack Towarnicky, an ERISA/Employee Benefits compliance and planning attorney, having over forty years of experience in human resources and plan sponsor leadership roles joins ehealth Radio and the Healthcare and Legal Channels.
Listen to interview with host Eric Michaels and guest Jack Towarnicky discuss the following:
Americans are anxious over “what’s next” in terms of increases in the cost of medical coverage and their out-of-pocket expenses, and how they will add to the existing financial stress from recent inflation and the decline in economic activity in the first half of 2022. What is your outlook?
There isn’t widespread agreement about whether we are in a recession. Regardless, how will the recent decline in economic activity be different this time?
Most American workers would be surprised to find out that they pay more for other people’s subsidized health coverage than for their own. Who pays, and how much? And, how much more are taxpayers going to pay into this?
What is the expected impact of current inflation and economic trends on employer-sponsored coverage?
How should employers and employees be thinking about health plan renewals for 2023? What actions should they be taking now, today?
What can employers and employees do about the looming increase in medical costs for 2023?
Jack Towarnicky Member, aequum LLC
As an ERISA/Employee Benefits compliance and planning attorney, Jack has over forty years of experience in human resources and plan sponsor leadership roles. This includes twenty-five years as the leader of a Fortune 100 corporation’s benefits function. While serving in those roles, Jack and his team won a multitude of individual, team and corporate recognitions. In 2020 Jack joined aequum and provides plan drafting and compliance services to employers and plan sponsors.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
 
 
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 

An Opportunity to Lower Medical Costs

 
Christine Cooper, the CEO of aequum LLC and the Co-Managing Member of Koehler Fitzgerald LLC, a law firm with a national practice along with Jack Towarnicky an ERISA/Employee Benefits compliance and planning attorney, having over forty years of experience in human resources and plan sponsor leadership roles joins eHealth Radio and the Healthcare and Legal Channels.
Listen to interview with host Eric Michaels and guests Christine Cooper & Jack Towarnicky discuss the following:
Christine, will the No Surprises Act protections against balance billing save workers money?
Jack, surveys show a majority of Americans are concerned about medical bills.  Won’t the No Surprises Act eliminate those concerns?
How can employers help alleviate “financial fragility” when it comes to the medical expenses their employees are not prepared to pay?
How could health care consumerism potentially transform future health care coverage?
What resources and services are available to help participants in a health plan defend against receiving unreasonable or excessive medical billing?
 
Christine M. Cooper, CEO and Member, aequum LLC
Christine M. Cooper is the CEO and Member, of aequum LLC. A patent lawyer recruited to Koehler Fitzgerald LLC in 2016 because of her large law firm experience and IT skills, Christine was quickly elevated to a member of Koehler Fitzgerald LLC and leads the health care practice. Christine is the CEO of aequum and is dedicated to assisting and defending plans and patients.
Jack Towarnicky Member, aequum LLC
As an ERISA/Employee Benefits compliance and planning attorney, Jack has over forty years of experience in human resources and plan sponsor leadership roles. This includes twenty-five years as the leader of a Fortune 100 corporation’s benefits function. While serving in those roles, Jack and his team won a multitude of individual, team and corporate recognitions. In 2020 Jack joined aequum and provides plan drafting and compliance services to employers and plan sponsors.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 
 

No More Surprises! How Provisions of the No Surprises Act Will Impact Employer-Sponsored Health Plans In 2022

 
 
Jack Towarnicky, an ERISA/Employee Benefits compliance and planning attorney, having over forty years of experience in human resources and plan sponsor leadership roles joins ehealth Radio and the Healthcare and Legal Channels.
Listen to interview with host Eric Michaels and guest Jack Towarnicky discuss the following:
What’s your best advice for workers when it comes to “Surprise” medical bills?
As an employee benefits expert, what advice can you offer employees that is most beneficial regarding their employer-sponsored health plan?
I thought you had to enroll in a health plan with a high deductible to be eligible to contribute to a Health Savings Account. Is this true?
Let’s say my employer offers two different PPO options, one with a $600 deductible and the other is HSA-capable with a $1,400 deductible. Why would I sign up for the higher deductible option?
Given that the employer spend is usually the same for all coverage options, why would they offer HSA-capable coverage? 
Jack Towarnicky Member, aequum LLC
As an ERISA/Employee Benefits compliance and planning attorney, Jack has over forty years of experience in human resources and plan sponsor leadership roles. This includes twenty-five years as the leader of a Fortune 100 corporation’s benefits function. While serving in those roles, Jack and his team won a multitude of individual, team and corporate recognitions. In 2020 Jack joined aequum and provides plan drafting and compliance services to employers and plan sponsors.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
 
 
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 

How to Navigate Health Insurance Benefits Whether You’re Employed, Unemployed and Self-Employed

 
 
Laura Adams, a Senior Analyst with USInsuranceAgents.com, who is a nationally recognized finance and insurance expert joins eHealth Radio and the Health News and Health Insurance Channels.
Listen to host Eric Dye & guest Laura Adams discuss the following:
What should listeners do to protect their finances if they don’t have health insurance?
If you’re thinking about leaving a job with health insurance to become self-employed, what steps should you take to get coverage?
Are there any changes in 2022 for health savings accounts (HSAs) we should know?
What’s the difference between an HSA and a flexible spending arrangement (FSA)?
If you have an HSA, what happens to it if you become unemployed, uninsured, or change jobs?
What are some tips to get the most from your health plan?
Laura Adams, MBA, is one of the nation’s leading finance, insurance, and small business authorities. As an award-winning author, spokesperson, and host of the top-rated Money Girl podcast since 2008, millions of readers, listeners, and loyal fans benefit from her practical advice.
Laura is a trusted source for national media who frequently seek her practical advice on various finance topics for TV, radio, online articles, and print publications. She’s been featured on most major news outlets, including ABC, Bloomberg, CBS, Consumer Reports, Forbes, Fortune, FOX, Money, MSN, NBC, NPR, NY Times, USA Today, US News, Wall Street Journal, Washington Post, and more.
Her mission is to empower consumers to live healthy and rich lives by making the most of what they have, planning for a secure future, and making smart money decisions every day. She received an MBA from the University of Florida and lives in Vero Beach, Florida.
Website: https://usinsuranceagents.com
Social Media Links:Facebook: https://facebook.com/usinsuranceagentsLinkedin: https://linkedin.com/in/lauradadamsTwitter: https://twitter.com/usinsuranceagts

No More Surprises! Provisions of the No Surprises Act Will Protect Healthcare Consumers Against Certain Out-of-Network Balance Billing In 2022

 
 
Christine Cooper, the CEO of aequum LLC and the Co-Managing Member of Koehler Fitzgerald LLC, a law firm with a national practice. Christine leads the firm’s health care practice and is dedicated to assisting and defending plans and patients joins ehealth Radio and the Healthcare and Health News Channels.
Listen to interview with host Eric Michaels and guest Christine Cooper discuss the following:
aequum was launched nearly a year ago. During that time aequum successfully resolved 6,000+ claims – saving over $31 million (97.2%) of disputed charges. What drove the formation of aequum and demand for your technologies and services that support health plans with medical billing?
What is “Surprise Medical Billing” and how does it impact our healthcare system?
What led to federal legislation and the significance of the No Surprises Act (NSA)?
What medical services and claims are protected by NSA?
When will the rules and provisions of the NSA take effect?
What strategies can employer-sponsored health plans and their members take to prepare?
Christine M. Cooper is the CEO and Member, of aequum LLC. A patent lawyer recruited to Koehler Fitzgerald LLC in 2016 because of her large law firm experience and IT skills, Christine was quickly elevated to a member of Koehler Fitzgerald LLC and leads the health care practice. Christine is the CEO of aequum and is dedicated to assisting and defending plans and patients.
About aequum
Founded in 2020, aequum LLC serves third-party administrators, medical cost management companies, stop-loss carriers, employer-sponsored health plans and brokers nationwide to protect plan participants, improve employee satisfaction with their health care plans, and generate plan and participant cost savings. aequum helps patients defend medical balance bills and brings savings to employer-sponsored health plans by providing administrative and other services to its partners. In addition, its sister organization, Koehler Fitzgerald LLC, provides legal advocacy to plan participants.
Website: https://aequumhealth.com 
Social Media Links: Facebook: https://facebook.com/aequumbykoehlerfitzgerald Linkedin: https://linkedin.com/company/aequumllc/about Twitter: https://twitter.com/aequumhealth 

How to Be Your Loved One’s Best Advocate through an ICU Stay

 
 
Dr. Lara Goitein, MD, a Harvard trained physician specializing in intensive care and lung medicine joins eHealth Radio and the Healthcare and Health News Channels. Her professional interests include quality improvement in healthcare, end-of-life care, the training of new doctors, physician burnout, and improving communication with patients and families. Her new book is The ICU Guide for Families: Understanding Intensive Care and How You Can Support Your Loved One.
Listen to interview with host Eric Michaels and guest Dr. Lara Goitein discuss the following:
You worked as an ICU doctor for twelve years in several different hospitals. But in the past several years you’ve transitioned to practicing mostly in your other area of expertise, as a specialist in lung diseases, as well as in hospital quality improvement. Do you miss practicing ICU medicine? Did you like it?
Why did you write this book?
What are examples of some of the practical ways people can help their loved ones when they are admitted to the ICU?
Are there commonalities in the way family members cope with the stress of an ICU admission for a loved one?
As you point out, family members are often desperate for information about their loved one’s condition. But they sometimes find it difficult to know when and how to communicate with the doctors in the ICU. Do you have any advice?
How is ICU medicine during the COVID-19 pandemic different?
Family members are sometimes asked to make very tough decisions on behalf of patients who are not awake or otherwise able to make decisions on their own behalf. This includes decisions about withholding or withdrawing of life support. In your book you offer some suggestions for how to approach these decisions. Could you talk about that?
Lara Goitein, MD, is a Harvard trained physician specializing in intensive care and lung medicine. She founded a clinician-directed quality improvement program at a Santa Fe, New Mexico, hospital and is President-Elect of the Medical Staff.
Her professional interests include quality improvement in healthcare, end-of-life care, the training of new doctors, physician burnout, and improving communication with patients and families. She is an editorial board member and frequent writer for the medical journal JAMA Internal Medicine, and also writes in the lay press, including the New York Review of Books.
Her new book is The ICU Guide for Families: Understanding Intensive Care and How You Can Support Your Loved One (Rowman & Littlefield, Dec. 1, 2021).
 
 
Website: https://medicalexplainer.com