Our Blog: The New Healthcare Marketplace

America’s new market-driven healthcare system offers huge opportunities for all players in the commercial health insurance ecosystem – employers, advisors, professional benefits administrators, and carriers alike. Our blog presents vital information and knowledge you need to not only comply with, but also to benefit from, and win.

The New Definition of Plan Metals

Within health plan design offerings, there are four categories, or metal levels, made available to employers and their employees. These levels are listed by the split of costs between the enrolled individual and the health plan. See chart below:  How you and your insurance plan split costs The decision process behind enrollment within these plans

Read More »

Health Insurance Premium Rebate Checks Aren’t Good News for America

Ever since 2012, Americans have received rebate checks from their health insurers when the Medical Loss Ratio doesn’t “measure up” to the 80/20 Rule.  In simple terms, the Rule means that insurers must spend 80 percent of their revenue from premiums to pay for the healthcare of their subscribers.  The other 20 percent is theirs to keep.  What

Read More »

An Act of True Bipartisanship: The No Surprises Act

On July 1, 2021, the Biden Administration issued its interim final rule cementing into place the No Surprises Act, which was signed into law by the Trump Administration on December 27, 2020.  The Act is one of the most important consumer protection measures regarding healthcare—ever.  It takes effect on January 1, 2022.  And in these days of so

Read More »


Download the full Planning Guide
Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule

Vincible Ignorance – One of the Problems with ESHI

Employer-sponsored Health Insurance (ESHI) covers just over 55 percent of the U.S. population and accounts for just over a third of the overall health care expenditure for the country. With such significant dollars allotted, expectations for the quality of healthcare and the overall health of individuals would be at the top of every health-related metric

Read More »