America's Benefit Specialist January-February 2023

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January/February 2023

31 Plan News 31 Medicare Conferences


2 The Dawn of NABIP 5 Noteworthy 8 Beware the Chronophage By Carol Matznick 10 Recent Mergers and Acquisitions 13 Product News 17 Presenteeism’s Impact on Workplace Productivity By Brenda Smith 18 Is It Just the Acronyms or Is It All Confusing to Employers? By Dorothy Cociu 24 Industry Events 26 People on the Move

YOUR SALES 33 The Benefits,and

Drawbacks, of ICHRAs By Connor Sir


35 Voluntary Disruption

Hi, My Name is Eric, and I’m a Recovering Carrier Rep By Eric Silverman

YOUR ASSOCIATION 37 CPC Quiz 39 Gordon Award Nominations 40 Welcome to NABIP 41 Congratulations Registered Employee Benefits Consultants! 42 NABIP’s Board of Trustees



29 Survey Shows Expanding Medicare Services Is More Popular than Lowering Age of Eligibility

43 Your NABIP Staff 44 Association Events

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O n January 1, NAHU became NABIP, the National As sociation of Benefits and Insurance Professionals! This is the result of delegates at last year’s Annual Convention voting overwhelmingly to update NAHU’s name. Before that, a task force was formed in November 2021 to explore the possibility of a name change. Eight people representing different parts of membership were recruited. Their mission was to explore the possibility of a name change that ensures the proper balance of respect ing NAHU’s past while providing clarity of our current and future value proposition. The task force organized roundtable discussions, took polls and had conversations with hundreds of association leaders around the country. They sought a new name that would be inclusive and represent the various roles filled by our mem bers (brokers/carrier reps/other solutions providers – and those who serve groups/individuals/seniors). They wanted a name that would carry authority and be simple for someone outside the association to understand what our members do. After much work and input frommany individuals, the National Association of Benefits and Insurance Professionals rose to the top. NABIP and our new tagline, Shaping the Future of Health care, protect the association’s legacy of leadership while rep resenting our current role in the modern healthcare industry. During every phase of the rebranding initiative, it was critical to respect our association’s rich history and provide a clear direction for our current and future value proposition. As a result, the new brand speaks to our evolving role as responsi ble and respected advocates and thought leaders. While our name has changed, our mission and vision remain the same: We believe that all Americans should be empowered to make wise healthcare and benefits decisions

and have access to high-quality, affordable healthcare and related services. “As the insurance and benefits industry has evolved, the association has expanded its capabilities to offer its mem bers robust educational opportunities, conferences and busi ness-development tools,” said NABIP President Kelly Fristoe. “The association’s membership has also grown to encompass members who sell traditional health insurance products and members who offer non-traditional coverage options. The rebrand of the name and tagline is both inclusive and a far more accurate reflection of who NABIP is today.” Working closely with our members, we reimagined our primary branding, beginning with new logos for the national association and corresponding state and local chapters. We also updated the visual identity of our essential functions, like our foundation, political action committee and certifica tions, so that all elements of our brand are cohesive and ac curately represent NABIP. With this new visual brand refresh and, equally important, the alignment of how we position the brand among stakeholders, we are well positioned to raise awareness, interest and participation in NABIP chapters and programs across the country. “Our decades-long commitment to our members and their clients is at the core of what we do and who we are, and that commitment will never change. We are excited to adopt the new name as a clear reflection of our organiza tion’s evolution and role in helping our members navigate the ever-evolving health insurance and benefits market place,” said NABIP Chief Executive Officer Janet Trautwein. “Looking forward, our new identity will better represent our expanded membership and resonate with members of this growing industry.” For more information, and to help your chapter update its name, please visit | ABS 3

Join us!


EDITOR Martin Carr (202) 595 0724

ADVERTISING SALES The YGS Group (717) 430 2238

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GRAPHIC DESIGN The iMage Worx (703) 731 6515 PRINTER Walsworth (573) 442 8714 REPRINTS The YGS Group (717) 505 9701, x2205 Send editorial submissions to Back issues are $4 each. Call (202) 595 0724 MAILING ADDRESS 999 E Street NW, Suite 400 Washington DC 20004

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Solving Compliance Problems Managing Remote Employees NAHU Award Winners


advertisements or published articles. Send editorial submissions to: America’s Benefit Specialist Editor, 999 E Street NW, Suite 400, Washington DC 20004. America’s Benefit Specialist (ISSN 2475-5826, publication no. 238660), 2022, volume 70, number 1 Published 10 times per year (January/February, March, April, May, June, July, August/ September, October, November and December) by the National Association of Benefits and Insurance Professionals, 999 E Street NW, Suite 400, Washington DC 20004. $25 annual subscription price is included in NABIP member dues. Periodical postage paid at Washington DC and additional mailing offices. POSTMASTER: Please send address changes to America’s Benefit Specialist, 999 E Street NW, Suite 400, Washington DC 20004.

Anatomy of a Bill Medicare Matters Value-Based Care

The YGS Group • 717-430-2238

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EYE CARE IN AMERICA Many people make it a priority to see their doctor at least once a year, but how often are Americans seeing their eye doctors? NVISION surveyed more than 1,000 people across the U.S. to find out what’s holding them back from prioritizing their visual health. For many people, cost and distance are contributing factors, as the aver age American lives around nine miles from their eye doctor. The report also provides insights into the states dealing with the biggest eye doctor disparities. Are Americans consistently making the trek to get their eyes checked? Ac cording to respondents, 48% go at least once a year, 21% every two years, 18% visit every three to five years, 10% go every six to 10 years, and three percent have never been to the eye doctor at all. Overall, the majority of Americans (63%) do not have vision insurance. This may come as a surprise because many people report needing assistance when it comes to their vision. Seventy percent of Americans have prescription glasses, 23% wear prescription contacts, 13% use reading glasses, and three percent have had laser eye surgery. One of the most common reasons for needing vision assistance is refractive errors, which in clude blurred vision, near-sightedness, far-sightedness and astigmatism. Over half (58%) of Americans report having refractive errors. Although some people haven’t recently visited an eye doctor, 53% had their vision checked in the last year. Ad ditionally, 20% had it checked two years ago, and 27% had it looked over more than three years ago. There are four primary types of vision specialists, and many Americans are unfamiliar with the differences. The two most common specialists are an optometrist and an ophthalmologist, and 58% of Americans don’t know the difference between them. An ophthal mologist treats eyes requiring medical or surgical interventions. Meanwhile, NOTEWORTHY

impact on general eye health in those states? Per 100,000 residents, West Virginia has the highest rate (4,094) of people reporting blindness or severe difficulty seeing. Mississippi ranks second, with 3,356 per 100,000 peo ple dealing with severe vision issues. Arkansas follows, with New Mexico and Oklahoma rounding out the top five. When it comes to how much optom etrists are being paid, there’s a big dif ference across the country. Connecticut ranks first for being the state with the highest-paid optometrists. The annual wage hovers around $155,070. Mary land has the second-highest annual pay, at $144,570. Following Maryland is Alaska, at $143,260. The states where optometrists are getting paid the least are Idaho at $85,200, followed by South Carolina ($101,050) and West Virginia ($105,210). For more information, visit www. NEARLY 40% OF AMERICANS CONFUSED BY MEDICAL BILLS AKASA, a developer of AI for healthcare operations, recently released findings from a survey conducted on its behalf by YouGov. The survey findings high light uncertainty looms among patients about what is included in a bill and if they can pay – two factors that drive the most confusion on medical bills. How ever, there are strategies healthcare organizations can take to be proactive and prevent billing surprises from trick ling down to patients. More than 2,000 Americans were asked: “On a scale from 1-5 (1 being not confusing at all, 5 being extremely con fusing), how confusing are medical bills to understand?” • 11% found medical bills not confusing at all • 14% leaned toward medical bills not being confusing • 37% said they were neutral on the confusion of medical bills

an optometrist manages, treats and diagnoses eye diseases. Among Americans who currently have an eye doctor, it takes the aver age person 21 minutes to get to their optometrist and, on average, people live nine miles away. The most com mon ways people find their doctor are through family recommendations (30%), an online search (27%), an insur ance provider (20%) and a recommen dation from a friend (10%). Forty-eight percent report last seeing their eye doctor in 2022, followed by 34% who went in 2021, 10% who had an appointment in 2020, and eight per cent who haven’t been to the eye doc tor since 2019 or earlier. Despite having an optometrist, 30% of Americans avoid going to the eye doctor due to cost. Among the 38% of Americans who don’t currently have an eye doctor, 33% say they don’t need one. Other reasons why people haven’t established care with a doctor include not being able to afford it (18%), not having the time (16%), being uninsured (15%) and not finding a doctor they like (15%). Additionally, nearly one in four have struggled to make an appointment at an eye doc tor’s office. When it comes to eye-doctor dispar ities across the U.S., some states are faring better than others. Using data from the U.S. Bureau of Labor Statistics, we find that Nebraska ranks first in the country with the best patient-to-doctor ratio of 4,675:1. Following the Cornhusk er state are Rhode Island, Montana, North Dakota and California. Louisiana takes the top spot for the worst patient-to-optometrist ratio in the nation at 18,496:1. Tennessee ranks second, followed by South Carolina, New Jersey and Mississippi. Overall, one in six people doesn’t think there are enough eye doctors where they live and 14% report strug gling to find an eye doctor. With eye-doctor disparities there comes a concern for people living in certain states. Does this have any | ABS 5


or a loved one. It called for a national long-term care navigation hub to help older adults discover and assess options, educate them on available support and funding, select and connect with the option that is best for them, and con tinuously evaluate their needs as health and financial statuses change. Naviga tion resources are needed immediately to support the aging Baby Boomer pop ulation, many of whom not only serve as caregivers to older parents but will soon need long-term care themselves. The poll was conducted between November 11 and 14, during a monthly Omnibus survey. It included 1,014 inter views with a nationally representative sample of adults age 50 and older. LARGE SHARES OF WOMEN REPORT NEEDING MENTAL HEALTH SERVICES BUT MANY DON’T GET THEM An analysis of 2022 KFF Women’s Health Survey (WHS) data finds that although large shares of women report needing mental health services over the past two years, a significant per centage did not access services they felt they needed. Fifty percent of wom en ages 18-64 say they needed mental health services in the past two years (including 64% of women ages 18-25), but only half of these women obtained an appointment, which may suggest unmet mental health care needs. Among those who felt they needed care, one in 10 (10%) tried to get care but were unable to make an appoint ment for mental health services. Anoth er 40% did not try to get mental health services even though they say they needed them. Research has documented the chal lenges some consumers with health in surance face when finding in-network care. In fact, two in 10 privately insured women with a mental health appoint ment in the past two years say their provider did not accept their insurance. The country also faces a workforce shortage of behavioral health profes sionals in addition to other affordability

• 19% found medical bills somewhat confusing • 19% said medical bills were extremely confusing Additionally, respondents were asked: “Which, if any, of the following is most frustrating about the financial experi ence after seeking medical care?” Amer icans ranked the following statements as their most important frustrations: 1. Being able to understand what they’re being billed for (29%) 2. Uncertainty if they can pay the bill (27%) 3. Not getting bill until weeks after they received service (24%) 4. Uncertainty if the final bill will be consistent with the estimate of re sponsibility (20%) The survey also asked: “Which, if any, of the following would be most helpful to you in understanding how much you are expected to pay for care or services?” • 27% said a call before the procedure from the physician’s office or hospital staff to walk through what’s expect ed in terms of payment and discuss payment plans offered • 12% said an online calculator to help determine cost ranges for care or procedures • 11% said an email from the insurance company to walk through the bill after care or services are rendered • 9% said a call from the insurance company to walk through the bill after care or services are rendered • 9% said access to live online custom er service through their insurer’s websites • 8% said a call from the physician’s of fice or hospital staff to walk through the bill after care or services are rendered • 24% said none of the above These results show that medical billing is still a black box to patients. The onus

is on healthcare organizations—both providers and insurers—to make medical billing less painful for patients, who may fear going into debt and avoid seeking out care. One critical tool healthcare leaders can leverage to course correct on medical billing and make it more seam less for patients is automation. Automation makes it possible to take a lot of the tedious work off the plates of revenue cycle specialists, freeing them up to become patient advocates. For example, automating authoriza tion status frees staff up to help with initiating an authorization in a more timely manner while also preventing appointments from getting canceled. Staff can also take on more patient-fac ing activities like financial counseling to deliver a better experience overall. Learn more at ONE IN FOUR OLDER ADULTS NEEDED LONG-TERM CARE FOR THEMSELVES OR A LOVED ONE IN 2022 Twenty-four percent of U.S. adults ages 50 and older say they, or a loved one needed long-term care in the past year, according to a new national survey. According to the survey findings, most older adults said the process of select ing long-term care caused anxiety (53%) and frustration (52%), while few said they felt confident (23%), at peace (23%) or happy (14%) while making a choice. Finally, the survey respondents said it was extremely important to have additional information about the cost of care and options to pay for it (69%) and the different types of long-term care services available (63%). The findings illustrate the wide spread need for information and guidance about long-term care services among an aging population and their caregivers, a need that experts say will grow exponentially in the future. Nexus Insights released a report earli er this year detailing the often frustrat ing and confusing process facing many older adults when making decisions about long-term care for themselves

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family member or friend, and members of the LGBTQ+ community. Rob Jekielek, managing director of The Harris Poll, said, “With the evolution of online patient portals and digital sup port tools, we have seen stronger usage among those who need to navigate the system the most—individuals with a chronic illness or disability and those who manage the healthcare needs of others. However, this has not translat ed to substantially lower frustration with the healthcare system, including understanding of coverage and claims. Confusion and uncertainty are even higher among the majority of Ameri cans who use the system sporadically, or only when specific needs arise.” Additional findings from the MITRE- Harris Poll Survey include: When consumers have a concern or question about a bill, they struggle with whom to call. Fifty-four percent of insured individuals in the United States say they don’t know whom to contact if they have an issue with a bill or claim. Individuals self-identifying as disabled or dealing with chronic illness, caregiv ers, Hispanics and younger generations are more likely to say they do know whom to contact if they have issues. The prevalence of unexpected med ical bills decreases slightly. Forty-three percent of insured Americans report receiving an unexpected bill because their insurance did not cover as much as expected—a decrease from a 2021 MITRE-Harris Poll Survey, when 47% reported a billing surprise. Patients are overwhelmingly using portals. Nearly nine in 10 insured individ uals use online patient portals more of ten for test results (70%), appointments (64%) and medical records (63%) than for other applications, such as finding a healthcare provider (58%), reviewing insurance benefits (54%), managing prescriptions (54%) or filing a health insurance claim (37%). Insured black, Indigenous and people of color (BIPOC) groups are more likely than white indi viduals to use patient portals to find a healthcare provider or file a claim.

challenges with health care infrastruc ture that impede accessibility. Among the one in six women who say they needed and sought mental health care services but were unable to get an appointment (16%), one-third say the main reasons they were unable to get an appointment were that they could not find a provider that was accepting new patients (33%) or that they could not afford the cost of mental health services (33%). Conducted periodically since 2001, the 2022 KFF Women’s Health Survey (WHS) includes a nationally represen tative sample of 5,145 women and 1,225 men ages 18-64 conducted primarily online from May 10 to June 7. The KFF analyses present the state of health services access and utilization among women and men by income, race and ethnicity, insurance status and other demographic characteristics. SURVEY: HALF OF PATIENTS IN THE UNITED STATES FEEL IGNORED OR DOUBTED WHEN SEEKING MEDICAL TREATMENT A new MITRE-Harris Poll Survey on Patient Experience finds 52% of indi viduals in the United States feel their symptoms are “ignored, dismissed or not believed” when seeking medical treatment. That number rises to six in 10 within the Hispanic community. The polling also revealed that more than half of blacks and Hispanics feel the “healthcare provider is biased against me based on their attitude, words or actions,” contributing to a four in 10 average across all demographics. Fifty percent (50%) of respondents also reported “a healthcare provider as suming something about me without asking me.” Additionally, the results indicate that several groups are all much more likely to experience bias, doubt or language barriers when seeking treatment. These include individuals identifying as a per son with a disability or having a chronic health condition, those responsible for managing access to healthcare for a

Patients seeking some specialists may wait two months or more for a vis it. While most Americans can schedule an imaging appointment or a visit with their primary care provider or general practitioner in less than two weeks, one in five say it can take two months or more to meet with specialized professionals such as mental health providers, specialty physicians, dentists or optometrists. This survey was conducted online within the United States, September 27-29, among 2,047 adults (ages 18 and over) by The Harris Poll. TELEHEALTH PREDICTIONS AND INSIGHTS FOR 2023 In the early years of the pandemic, telehealth emerged as a critical means to ensure access to healthcare and medical services. Almost three years later, telehealth has shifted from novel to normal, becoming a standard aspect of care delivery for most practices and hospitals. Now, a big question remains: Can the traction and promise of telehealth to increase access to care continue to extend throughout the years ahead? A new report, Telehealth in 2023, issued by national healthcare consul tancy Sage Growth Partners (SGP), un covers answers to many key questions relating to the future of telehealth. The report provides predictions, perspectives and insight to questions such as: • Has telehealth usage reached its peak, or will practices and hospitals further expand services in 2023? • What key objectives will practices and hospitals hope to achieve by of fering telehealth services in the year ahead? • How do practices and hospitals be lieve telehealth is impacting clinical outcomes—and how might that change in 2023? Continued on page 25 | ABS 7


By Carol Matznick Director of Marketing Triune Technologies Greensboro, North Carolina

No matter how many business hats you wear, you are, first and foremost, a salesperson. But how much of your time do you spend. . . selling? It is probably less than you think. According to the Center for Sales Strategy, data suggests that you only spend 30% of your time in actual sales-related activities. Included in that 30% are things like: time finding and qualifying new prospects; time and effort to set first ap pointments; discovery work with either a new prospect or an FIND A BA COMPANY FOUNDED BY ADVISORS JUST LIKE YOU AND NOT BY A BUNCH OF CODERS WHO DON’T KNOW THE INDUSTRY.

existing upsell opportunity; developing ideas and proposals; presenting proposals; and closing the sale. WHAT IS A CHRONOPHAGE? A chronophage is a sneaky beast keeping you from grow ing your practice—and you probably aren’t even aware it is happening! It is the critter eating the other 70% of your time. The word comes from the Ancient Greek words chronos and phage , which means “things that eat your time.” There are a few things to consider to stop feeling like your time is being nibbled to death by ducks. First, ask yourself if you are doing work that a service person could/should be doing. It is tempting to put off hiring account managers be cause of the cost of a full-time employee but, if you do the math, that is a false economy. Instead, consider how much more you could make if you spent that time on client-facing activities. Then there are the chores that are an inescapable part of the group medical business—chief among them the initial enrollment and the ongoing service requirements. For years,

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advisors in the larger group market have used benefit- administration (BA) systems to help automate that process. Recent developments in the BA market have seen some of those systems reprice to be more affordable for the small group market. But our old friend the chronophage is also hiding in some of those solutions, ready to feast on your perceived produc tivity increase! While it sounds simple, using a BA system has some things to consider beyond its curb appeal. THE INTANGIBLES Many advisors don’t contemplate the time cost of setting up the case on the software. But the actual hidden cost of case setup is the enormous opportunity to make a mistake that affects employees and your client relationship, which can be costly in other ways. Check your E&O insurance to be sure a slip-up like that is covered. Find a BA company that does the setup for you to avoid the problem. You save time, avoid liability and don’t risk your client relationship. Then there are the dreaded EDI feeds, where the carrier and the client entity exchange information. Once again, the chronophage is ready to pounce—unless you ensure that the BA company handles all the EDI setup and testing. Once again, you save the time of learning how to create those feeds, and you avoid liability. PEDIGREE MATTERS So that you don’t have to educate anyone other than your cli ent and your team, find a BA company founded by advisors just like you and not by a bunch of coders who don’t know the industry. People dealing with the same issues you do are more likely to understand the nuances of the client-car rier-employee dynamic and to have crafted a solution that pleases all those constituencies. There is one important thing to look for so that you can spend your time growing your revenue rather than fussing

with a BA system while the chronophage gets fat and happy: You want a system with what developers call “mature busi ness rules.” Those are the behind-the-scenes bits of logic that let you handle irregular pay periods, create unusual employ ee classifications, etc., in a way that won’t break the system. Ask how long the system has been in place and how often it gets updated. THIS ISN’T SUNDAY DINNER There are times when passing things around makes sense: mashed potatoes at family dinner, a football, or the latest water-cooler gossip. What should NOT be passed around is . . . you! Make sure the company you decide to work with has one contact—a “go-to” person for everything you need. They become familiar to you and create an extension of your team. There are few things more time-consuming than playing pass the call as you fume waiting to get the right person to answer your question. IT ISN’T GOING AWAY The chronophage has been around for a long, long time. Benjamin Franklin knew about it when he said the phrase all advisors should use to slay the beast: “Time is money.”

Carol Matznick is a long-time member of the NABIP community and currently serves as president of the North Carolina AHU. Carol served NAHU as a member of the national Board of Trustees. She was director of the NCAHU for 23 years before joining Triune Technologies, founded by three benefits advisors, one of whom was Bynum Tuttle

(retired), a former president of NAHU. She is active in her church and community and ready to jump in and serve when needed. | ABS 9


Work). This insurance brokerage group designs and implements voluntary employee benefits solutions. VB@ Work combines state-of-the-art bene fits analysis, communication, enroll ment, billing and support services, providing a strategic competitive advantage for the company across the benefits industry. “We are excited about what Volun tary Benefits at Work will bring to our partner network,” says Peter C. Foy, chairman, founder and CEO of PCF Insurance. “In a time when the average employee is highly tuned in to these types of benefits, its focus on the ancil lary benefits is unlike most in the indus try. Adding this niche offering to PCF Insurance’s portfolio of agency partners expands coverage of our offerings and increases the availability of innovative protection against unique risks.” “PCF Insurance was the best fit to drive our high-growth niche insurance agency to its full potential. We enjoy solid working relationships with many large and small professional health and welfare benefits brokers who rely on our expertise. By joining PCF, we’ll be able to expand our offerings and create value for our clients and their employees,” said Tonya Lancaster, principal of VB@Work. AMERICAN HEALTH PLANS PARTNERS WITH INTEGRITY Integrity Marketing Group LLC has entered into an agreement to acquire American Health Plans, a health insur ance contact center headquartered in Detroit, Michigan. As part of the acquisition, Joseph Karam, president of American Health Plans, will become a managing partner in Integrity. Karam founded American Health Plans in 2014. The company specializes in ACA, Medicare, life insurance, group health and ancillary coverage. Amer

ican Health Plans helps and services thousands of Americans across the country with their health insurance needs, primarily by phone. American Health Plans also trains and services agents across the country. HILB GROUP EXPANDS MID ATLANTIC EMPLOYEE BENEFITS MARKET PRESENCE The Hilb Group has acquired Mary land-based Vinton Insurance Services, building on the company’s growing presence in the Mid-Atlantic region and further expanding its employee benefits client base and expertise. The acquisition took effect November 1. The business will join with Hunt Valley, Maryland-based PSA Insurance & Fi nancial Services, a Hilb Group agency. Based in Towson, Maryland, Vin ton Insurance Services specializes in providing a dedicated approach and total solution to the employee benefits needs of its customers. The agency focuses on reducing the complexity of the health insurance market for employers and individuals. Peter Vinton and his team of insurance profession als will become part of Hilb Group’s Mid-Atlantic regional operations. The Hilb Group has also partnered with Rhode Island-based OceanPoint Insurance. The transaction became effective December 1. Based in Middletown, Rhode Island, and with offices throughout the state, OceanPoint has been serving the southeastern New England community for more than 150 years. The agency provides complete property and casu alty products and solutions, as well as broad employee benefits offerings for their clients in both commercial and personal lines. Agency principal Doug Mayhew and his team of insurance pro

HUB INTERNATIONAL ACQUIRES THE ASSETS OF AM INSURANCE SERVICES Hub International Limited has acquired the assets of AM Insurance Services of Miami Inc. AM Insurance Services is an independent insurance brokerage firm that offers employee benefit products for small to midsize employers. Benefit packages include health, dental, vision, life, disability, long-term care and retire ment planning. Claudine Nelson, pres ident, and the AM Insurance Services team will join Hub South Florida. MEDICAL MUTUAL FINALIZES DEAL FOR RESERVE NATIONAL INSURANCE COMPANY On December 1, Medical Mutual closed on the acquisition of Reserve National Insurance Company, formerly Kemper Health. “We are very excited for the oppor tunities this acquisition affords,” said Tom Dewey, Medical Mutual executive vice president, corporate initiatives and chief people officer. “Reserve National has a strong suite of products that align well with Medical Mutual’s core offerings.” Reserve National is headquartered in Oklahoma City, Oklahoma, and cur rently has 176 employees and a network of approximately 600 independent agents. Reserve National operates in Ohio plus 44 other states and Wash ington DC. All 176 employees became Medical Mutual employees when the transaction closed. PCF INSURANCE SERVICES ANNOUNCES ACQUISITION OF VOLUNTARY BENEFITS AT WORK PCF Insurance Services (Lehi, Utah) recently announced its acquisition of Voluntary Benefits at Work (VB@

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fessionals will join the Hilb Group’s New England regional operations. ARTHUR J. GALLAGHER & CO. CONTINUES GROWTH Arthur J. Gallagher & Co. continues to grow. Among its latest acquisitions are: • Gallagher has reached an agreement to acquire the partnership interests of BCHR Holdings L.P., dba Buck. The transaction is expected to close during the first half of 2023, subject to customary regulatory approvals. Buck is a provider of retirement, HR and employee benefits consulting and administration services. The organization has a long history, dating back more than 100 years, with a diverse client base by both size and industry. With over 2,300 employees, including more than 220 credentialed actuaries, Buck primar ily serves customers throughout the US, Canada and the UK. • Gallagher also announced the acqui sition of St. Cloud, Minnesota-based Mahowald Insurance LLC. Founded in 1930, Mahowald is a retail insurance agency offering commercial and personal products, employee benefit packages and risk management ser vices for clients across the Midwest. Bob Mahowald, Jr., and his team will remain in their current location under the direction of Sean Gallagher, head of Gallagher’s Great Lakes region retail property/casualty brokerage operations, and Tom Lannen, head of Gallagher’s Midwest region employee benefits consulting operations. • Gallagher acquired Chicago-based ROC Group. Founded in 1998, ROC Group is an employee communica tion agency specializing in human resources and enterprise change solutions for clients across the United States. Jan Burnham and her team will join Gallagher’s employee ben

wellness needs; each person has differ ent wants, which are always changing based on time, circumstance, and even learning styles. But this doesn’t mean we throw in the towel,” said Amanda Lannert, CEO of Jellyvision. “Now, our joint technology offering will make con nections between increasingly complex wellness benefits and the people who need them. We’re striving to eliminate waste, complexity, and confusion so em ployees can finally understand, appreci ate and effectively use their benefits.” “Health insurance selections are more complex decisions than most people realize,” said Brian Morgan, president of Picwell. “We see that without proper education and guid ance, people make costly mistakes, both when choosing health plans and using benefits throughout the year. This is why we’re thrilled to join forces with Jellyvision to continue working towards our shared vision to simplify the healthcare benefits experience and empower everyone to make informed health benefits decisions.” ALLIANT INSURANCE SERVICES EXPANDS PRESENCE IN SACRAMENTO Alliant Insurance Services has acquired Polley Insurance and Risk Manage ment, expanding its reach in the Sacra mento region. Focused on commercial insurance, risk management, employee benefits and personal insurance, Polley creates customized programs that address the unique risks and exposures organizations and individuals encoun ter in today’s rapidly changing business landscape. Founded in 2001, Polley was named one of the Sacramento Business Journal’s Best Places to Work in 2022. Polley Insurance and Risk Management and its team will join the Alliant family of companies and continue to service clients from its Gold River, California headquarters.

efits consulting and brokerage op erations under the direction of Ben Reynolds, global managing director, employee experience and communi cation practice. • Gallagher announced the acqui sition of Abilene, Texas-based CBS Insurance LLP. Founded in 1992, CBS Insurance is a retail insurance agency providing property/casualty and health/benefits coverages to clients throughout Texas and the surrounding region. Peter Lauve, Steve Senter and their partners and associates will remain in their current location under the direction of Bret VanderVoort, head of Gallagher’s South Central retail property/casualty brokerage operations. • Finally, Gallagher has acquired Cor porate Insurance Analysts Inc., dba MGC Group, and The Agents Asso ciation of FB Companies (AAFBC). Founded in 2004, MGC Group and AAFBC provide association guaran teed issue group insurance benefits to captive independent contractors under the direction of Kevin Garvin, head of Affinity North America for Gallagher’s retail property/casualty brokerage operations. JELLYVISION ACQUIRES PICWELL Jellyvision, the company behind ALEX, an employee benefits engagement technology, has acquired Picwell, a healthcare technology company focused on AI-generated benefits de cision support. Together, the two SaaS companies will offer a benefits experi ence for employees, leveraging behav ioral science and predictive analytics to deliver personalized benefits recom mendations and ongoing engagement. “There is no one-size-fits-all solution to meet employees’ unique health and across multiple states. John Mat thews and his team will operate | ABS 11


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their benefits. The new medical true own-occupation definition is robust. Its earliest iteration was initially intro duced in 2009 based on direct input from physicians about their under standing and expectations as it related to their personal disability income in surance policies. Medical professionals will now have the choice between the following definitions of disability: True Own-Occupation: If medical professionals are totally disabled, unable to perform the substantial and material duties of their regular occu pation, and they choose to work in an occupation other than the regular oc cupation at the time of onset of disabil ity, they will be eligible to receive their full monthly benefit for total disability regardless of the income they earn from working in the new occupation. Medical True Own-Occupation: If medical professionals are unable to perform the substantial and material duties of their regular occupation that generate 50% or more of their direct patient-care billings (e.g., procedural duties), but they are still able to perform one or more of the other substantial and material duties of their regular oc cupation (e.g., clinical duties), they can choose not to work and still be eligible to receive their full monthly benefit. Additionally, the medical true own- occupation definition provides the same protection to medical professionals as is provided by the true own-occupation definition. If medical professionals are totally disabled, unable to perform the substantial and material duties of their regular occupation, and they choose to work in an occupation other than the regular occupation at the time of onset of disability, they will be eligible to receive their full monthly benefit regardless of the income they earn from working in the new occupation. “Income protection is foundational to financial security in any financial plan, and it is especially important for medical professionals,” Williams-Kemp added. “When you begin your working

enrolled in PPO or HMO plans can access DispatchHealth services. While members with HMO plans must be referred by their primary care physi cian, those enrolled in PPO plans and Medi-Cal plans (in Los Angeles and San Diego counties) can receive access to DispatchHealth services by contacting Blue Shield of California Customer Care, Care Concierge or Nurse Hotline, or contacting DispatchHealth directly via its website. For more information, visit news. NORTHWESTERN MUTUAL EXPANDS DISABILITY INSURANCE CHOICES FOR MEDICAL PROFESSIONALS Northwestern Mutual is introducing additional flexibility and choice into its lineup of disability insurance solutions for medical professionals, includ ing physicians and dentists. Medical market clients will now have a choice between a true own-occupation defi nition and an enhanced medical true own-occupation definition when se lecting a policy to protect their income if they were to become totally disabled and could not work. “We ‘get’ medical professionals, and know they obtain disability insurance early in their careers and that a lot can change over time in terms of their primary income-generating activities. That’s why we have enhanced our medical true own-occupation defini tion that follows doctors and dentists throughout their careers and provides them with flexibility and choices in the event they become disabled,” said Ka milah Williams-Kemp, vice president of risk products at Northwestern Mutual. A disability insurance contract’s definition of total disability is import ant because it determines whether policyowners can collect some or all of

BLUE SHIELD OF CALIFORNIA INTRODUCES AT-HOME CARE SERVICES TO ACCOMMODATE MEMBERS’ BUSY LIVES Blue Shield of California members liv ing in Southern California now have ac cess to additional medical care services for a range of illnesses and injuries in the comfort and convenience of their homes through a collaboration with DispatchHealth. DispatchHealth offers in-home, same-day, high-touch care that is delivered by a team of trained medi cal professionals who can treat more than 40 health conditions, including conditions like respiratory infections, pneumonia and chronic obstructive pulmonary disease (COPD). Care is available in English and Spanish from 8:00 a.m. to 10:00 p.m. daily. Bridge care—assistance in transitioning high risk members from hospital care to home care—is also available to help members with their recovery and pre vent hospital readmissions. In Blue Shield’s recent test of Dis patchHealth service for the health plan’s members, more than half of those who used it did so after 5:00 p.m., which is when most primary-care offices are closed and often the busiest hours for emergency rooms. “With our DispatchHealth collabora tion, Blue Shield can provide a conve nient way for members to access qual ity care directly in their homes,” said Peter Long, executive vice president of Strategy and Health Solutions at Blue Shield of California. “Meeting members where they are and removing barriers to care with quality at-home medical services is part of our mission to provide healthcare that’s worthy of our family and friends and sustainably affordable.” Blue Shield of California members living in Los Angeles, Orange, River side and San Diego counties who are | ABS 13


age costs, filling in these gaps left by large insurance carriers. Pebble debuts at a time when small businesses, startups in particular, are at a distinct disadvantage in terms of the healthcare benefits they can provide employees. While large com panies have dedicated broker teams with the ability to develop customized plans structured specifically for their business—and at lower rates—smaller businesses generally have to make do with limited options available through off-the-shelf packages. Such packag es often exclude benefits like fertility assistance and mental health coverage, which have become important con siderations to employees. Over 60% of large companies aim to offer fertility benefits to their employees, but these benefits are unavailable to smaller companies outside Pebble. Additionally, the onboarding and user experience at startups leaves a lot to be desired, placing a heavy burden on HR teams that are already overextended. Pebble addresses all of these issues and more. Powered by AI, Pebble’s technology creates custom benefits packages for small companies that rival those offered by bigger corporations while providing member-care experiences that are hu man-centered and transparent. “Healthcare is one of the leading cost centers for startups, yet one that gets little attention. The options are difficult to navigate, and coverage almost never meets expectations,” said Manoj Pinna, co-founder and CEO of Pebble. “We can streamline the entire process for start ups, saving them an average of 20% on what they would be paying otherwise. And rather than put this savings back in their pockets, companies are reinvest ing it in additional healthcare services and more comprehensive benefits to better serve their employees. With Pebble, startups can compete with any company out there on benefits, which makes themmore competitive in the battle for talent at very little cost or hassle to themselves.” Pebble also takes on the forms, en rollment and payroll deductions while

life several years later than most and front-load it with significant student debt, you have to take steps to protect your earning potential. It is over the arc of their careers that medical profession als reap the benefits of their upfront investment in education and training and can secure long-term financial rewards and security.” Medical professionals who are ex isting policyowners will also be able to leverage the expanded choices. Those with recently issued disability policies can take advantage of these new ben efits without any additional underwrit ing, while clients with older policies will have the opportunity to acquire these options if they meet the typical applica ble underwriting requirements. BOSTON MUTUAL LAUNCHES INDIVIDUAL SOLUTIONS PROGRAM Boston Mutual Life Insurance Company recently launched its Individual Solu tions Program. This program was creat ed to provide accessible whole life and accident insurance options to under served markets across Massachusetts. “We are eager to further our in surance offerings with the Individual Solutions Program so more individuals and families across Massachusetts have access to the coverage they need,” said Joshua Police, executive vice president—distribution and business development at Boston Mutual. “This program offers insurance solutions for those who otherwise would not have access, ensuring local community members throughout the Greater Bos ton area and across Massachusetts can have the peace of mind they deserve.” According to the 2021 LIMRA Life Happens Insurance Barometer Study, only 52% of American adults have some type of life insurance coverage. The Individual Solutions Program offers the opportunity to purchase affordable coverage that’s easy to understand,

and the opportunity to connect directly with Boston Mutual’s insurance pro fessionals for a personalized customer experience. This ensures policies are based on the individual’s and family’s needs and preferences, so consumers are making informed decisions for their families and clients. “With the launch, we’ll be focusing on community engagement,” said Nicholas Barishian, vice president of individual solutions, who will be leading this program. “The community insights from focus groups we coordinated last year in partnership with LIMRA in Massachusetts indicated that consum ers want a facilitated experience. We are committed to doing just that with our team of insurance professionals to educate the end buyer to help them make informed decisions for them selves and their families. The Individual Solutions team has deep knowledge of insurance products and is passionate about providing peace of mind to local community members.” To learn more, visit PEBBLE AIMS TO CLOSE THE EMPLOYEE BENEFITS GAP Pebble, a new company dedicated to providing more comprehensive health benefits plans to startups, has publicly launched after completing a successful, invite-only beta program. Its financial engineering and technology applica tions build generous employee benefits plans within the ideal construct for employees and small companies while keeping costs under control. Pebble partners with all major health carriers to create packages tailored to each company’s needs, goals and budget. In addition to developing plans, HRAs and FSAs, Pebble steps up when benefits like mental health or fertility coverage can’t be negotiated or worked into a company’s package with a single carrier. It leverages tools available as a third-party administrator to help man

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