August 18, 2023

Unlike insurers whose plans must comply with strict metal tier and essential health benefit requirements, self-funded groups benefit from flexibility of plan design and offerings. However...

June 29, 2023

A former colleague came across an article I wrote last year, 'My Recent Experience with Kaiser Health System' – Axene Health Partners, LLC.  After reading the article, she reached out to ask my thoughts...

June 24, 2023

To achieve savings benefits from the coming wave of biosimilars, biosimilars must be adopted by prescribers, members, and payers (through their formulary strategies). While previous...

June 4, 2023

As with many things in life, change is challenging, often undetected when it starts, many times mislabeled as an aberration, but always important. As John F. Kennedy once said...

June 1, 2023

Once the first Humira biosimilar, Amjevita, launched in the United States in January, payers needed to begin making decisions about coverage not only for Amjevita but for all the other Humira...

April 6, 2023

Health insurers are required to hold minimum levels of surplus each year. However, the exact amount a health insurer chooses to hold can vary significantly from one insurer to the next...

March 24, 2023

For a healthcare system to run efficiently there is a balance that needs to be found where there is adequate staffing to accommodate the needs of a population. Too much staffing and supply...

March 17, 2023

In the world of employee benefits, organizations and brokers often find themselves struggling to get a clear picture of the entire health benefits landscape. For self-funded groups, the challenge lies in managing...

February 10, 2023

There is a coming wave of changes arriving soon to the pharmacy market in the form of biosimilars.  And that coming wave has a big event in 2023:  the launch of Humira biosimilars, which...