Chris Hamilton

Despite brokers reporting stable premiums, employees face rising healthcare costs through increased deductibles and out-of-pocket expenses. Texas employers pay hospitals up to 315% of Medicare's pay for the same procedures. This significant price disparity directly contributes to higher out-of-pocket expenses and in most cases higher health insurance premiums for "quality health insurance." Most brokers also have the same old tactics where they create urgency for employers to renew their plan 2-3 months early for reasons you can only assume based on what I just shared. Brokers also often deliver low premiums each year, creating the illusion of stable costs. However, the reality is that the quality of healthcare is decreasing as employees shoulder more of the financial burden. It's crucial to address these hidden costs and work towards better healthcare solutions. #employeebenefits #grouphealhinsurance #healthcare

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I always appreciate Sam’s posts as they are thoughtful and concise. What really upsets me about the letter from these Senators to CMS is how callously the word “brokers” is used in the paragraph below: —- “with more than $6 billion in MA plan spending on commissions and marketing, brokers are under pressure to churn through appointments as quickly as possible. The demand for volume means brokers are under pressure to focus on only a few plans and may not examine the full range of options” —- Let me be clear, the large majority of brokers are NOT under pressure to churn. We do NOT only examine a few plans. The actions being described are that of a call center. And therein lies the problem. The fact that our government officials clearly do not understand the difference between a call center and a broker is a tremendous problem. If we cannot educate our government officials regarding the difference, we are all going to be out of a career. Plain and simple. Pinnacle Financial Services, Inc. Tyler Insurance Group Angela Palo Kevin Shields Nick Palo NABIP Laura Tyler Andrew Horn, MHA Caroline Horn Eric Price, MBA Christopher Raon

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Are you familiar with "pre-authorization" for certain medical procedures? It's intended to help with cost containment in the U.S. healthcare system. But it really only contains costs for one side ... which are the large insurance carriers. This is a good read on how this "works" ... and what happens when it doesn't work for all parties. The result is not good. https://lnkd.in/gQJ5FFxG More importantly - do you have real advisors who are helping you contain your costs? If you're relying on your insurance broker, the answer is no. If you're working with Higginbotham, the answer is yes. And if you answered no - but want to answer yes - then give us a call. We will help you contain YOUR costs. Or just stay with the status-quo where you're outnumbered and paying more. It's your choice. Suzanne Dutwiler Tommy Taylor TJ Hutchings Kathleen Shivers LeAnne Gage Preston Lash Vanessa Benitez Tashara Houston Kim Baker Higginbotham Mitigate Partners

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Today, CMS released the average bid amount for Medicare Drug Plans in 2025 and the Medicare Part D base premium. Bid amounts increased by 280%, while the base premium increased modestly by 6%. Key Changes to Note: 1. Bid Amount Increase: The bid amount for Medicare Part D plans is seeing a substantial increase from $64.28 in 2024 to $179.45 in 2025. This change reflects the higher projected costs of providing prescription drug benefits as a result of the $2,000 maximum out-of-pocket cap in 2025. 2. Base Premium Adjustment: The base premium for Part D plans is also rising, moving from $34.70 to $36.78. This adjustment gives us an idea of what to expect for Medicare Part D premium increases. Why These Changes Matter: We knew the Inflation Reduction Act's $2,000 cap on annual out-of-pocket expenses for prescription drugs would be expensive. We just weren’t sure who would pay for it. Now we know that contrary to what was stated previously, the costs will be funded by the government/taxpayers. Watch my latest video, where I explain these changes in detail and discuss what they mean for Medicare beneficiaries. #CMS #MedicarePartD #DrugPlans #Healthcare #Medicare2025 #InsuranceIndustry #BidAmount #BasePremium #HealthInsurance

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RECENT CMS MEDICARE ADVANTAGE COMPENSATION RULE: "LIMITED TO INDEPENDENT AGENTS AND BROKERS AND DO NOT EXTEND TO TPMO'S (FMO'S) MORE GENERALLY" "CURRENT POLICY DOES NOT EXTEND TO PLACING LIMITATIONS ON PAYMENTS FROM AN MAO TO A TPMO" SEEMS CLEAR THAT A CHANGE IN THE FMO RELATED COMPENSATION & STRUCTURE IS NOT REQUIRED BY THE RECENT CMS RULE. https://buff.ly/3VkNxdf

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Today is the day! Join us at 3 PM EST for Cattie & Gonzalez, PLLC Quarterly Medicare Compliance Webinar From January to June of 2024, there have been significant Medicare changes announced, major new programs that will get started soon, and consequently numerous new Medicare related responsibilities for both plaintiffs and defendants in liability, no-fault, and workers compensation claims and litigated cases. Are you familiar with the various announcements? Do you understand the new requirements resulting from same? Is your institution ready for these new changes? Are your claims professionals ready to implement these latest mandates? If you are plaintiff or defense legal counsel, are you and your firm ready to advice your client on the potential effects of these latest policy requirements? Our webinar discussion today from 3 PM to 4 PM EST will focus on all of the recent announcements which the Centers for Medicare and Medicaid Services (CMS) has published during 2024 regarding the 3 major MSP compliance components- mandatory insurer reporting, conditional payments recovery, and future medical consideration. To join John Cattie, Rafael Gonzalez, and Jim Anderson's webinar conversation and discussion, please register at https://lnkd.in/eGMvE2Wa or contact us at www.cattielaw.com [email protected] 844.546.3500 #rafaelgonzalezesq #cattiegonzalezpllc #ahigherstandardinmspcompliance

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Understanding the Current Changes in Texas Health Coverage Recent developments in Texas are impacting health insurance coverage and access to care for many residents. Ongoing disputes between major health systems and insurers, shifts in Medicaid contracts, and potential hospital closures are contributing to uncertainty about healthcare options. For those seeking more details on these issues, this article provides an overview of the current situation: https://lnkd.in/g9WHQWrZ At Community Health Choice, we're here to help you navigate these changes. If you have any questions or need assistance, don't hesitate to reach out to us. #HealthCoverage #TexasHealthcare #CommunityHealth

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📢 Medicare Update: 2025 Part B Premium Increase Alert Attention Medicare beneficiaries! CMS has announced an increase in the standard Medicare Part B premium for 2025, now set at $185 per month, up from $174.80 in 2024—a 5.9% rise. Additionally, the annual Part B deductible will increase to $257 from last year’s $240. Higher-income beneficiaries will continue to pay more based on income brackets. This premium adjustment reflects rising healthcare costs and new policies to address drug pricing. Be sure to review these updates as part of your Medicare coverage planning for the upcoming year. Remember, the annual enrollment period closes December 7— contact us to review your options to ensure the best coverage for your needs. #Medicare2025 #MedicarePremium #MRInsuraceSolutions

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Press Release: Prime Insurance Introduces the TRU Solution for Reliable Coverage in Times of Crisis In the aftermath of recent storms and wildfires, policyholders need an insurance partner they can trust to provide comprehensive and straightforward coverage. Prime Insurance is proud to introduce the TRU Solution—designed to offer peace of mind through transparent, all-in-one coverage that responds when it matters most. Unlike policies that require separate coverage for risks like floods or earthquakes, Prime Insurance’s TRU Solution simplifies protection. Our approach ensures that customers know what to expect before a claim arises, with clear terms and prompt, fair service. We’re here to support our clients in both good times and bad, so they feel confident and protected. "Even my own son, Parker once thought our quote was too high, but when a wildfire came near, he realized how invaluable that coverage truly is," says Rick J. Lindsey, CEO of Prime Insurance. Prime Insurance stands by its clients, providing reliable, straightforward solutions. For more information on the TRU Solution and how XINSURANCE can meet your needs, contact us today. Contact Information: Agents : [email protected] Homeowners [email protected]

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https://lnkd.in/d8ZgabSA Takeaway: The Centers for Medicare & Medicaid Services (CMS) has released new data on risk adjustment payments for 2023. The agency said insurers participating on the Affordable Care Act's exchanges will pay $10.3 billion as part of the risk adjustment program. Risk adjustment state transfers as a percent of premiums declined from 2022, according to the report. This trend is likely driven by shifts in the risk pools, according to CMS, which are likely impacted by ongoing insurer expansion into new regions.

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Progressive Insurance withdraws from the Texas market due to heavy weather-related losses. About 40% of Progressive’s storm losses occurred in Texas. Texas’s hurricane and flood exposure is worrying the insurance world. Progressive is no longer offering home insurance to new homeowners in the Houston area; however, this will not affect their other products like auto insurance. Full article linked below in the comments. #propertyinsurance #weather 

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Be prepared for higher insurance rates and deductibles! 🆙🆙🆙. According to recent statistics, the region from North Carolina to Texas has experienced the second-most recorded tornadoes in history since April 25th. This has resulted in 39 states and 98 million Americans being under severe weather risk this week. When the capital markets that back insurance companies lose money, they raise their rates to reinsurance markets, reinsurance companies raise their rates to insurance, and then insurance companies raise it to us as consumers. As a result, insurance companies are adding or increasing wind hail deductibles, getting off property with older roofs or excluding them altogether, and some are even shutting their doors. It's not a profitable business to be in right now. So, it's advisable to put a little more money back for increase than you did last year. Protect yourself and your property! #insurance #insuracerates #beprepared

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Austin Littrell of Medical Economics offers some insight into Zocdoc's 2024 "What Patients Want" report on health care trends in the attached article. Good overview of the report as well as a link to the full report which offers 29 pages of statistics on a variety of relevant topics. Both are definitely worth a read. You may need to create a username and password to access the article, but there is no paywall.

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