yzerman19

Not my intent. You also seem to be very well versed in the subject matter

You're referring to economies of scale, which should occur at a large enough level of membership. The problem is those economies of scale just don't come to fruition on anything other than claims processing, which is truly as close to the clerical at you represented. So, a huge chunk of CEO comp is simply supply and demand on Wall Street. I mean its mostlymstockmoptions and grants that have nothing to do ( other than distantly) from the actual profit margin if the company. Also, united is a big, international conglomerate that makes more margin on non-insurance. Read big data and Optum. Ever wonder why every health plan is looking at vertical integration with providers or selling health and wellness? It's cause they need to find margin outside of insurance.

I've spoken with her and Zeke Emmanuel

Methodology is all Rbrvs, but the CF is negotiated. To those unfamiliar, physician compensation is based on a series of codes called CPT. Codes have a weight tied to them based on the resource intensity of the service they represent (RVU-relative value units). A simple office visit would have little RVUs, a heart bypass will have a lot of RVUs. The Conversion factor is negotiated. The conversion factor times the RVU nets the payment allowed by contract for the service. This is called the allowed amount.

I appreciate people's passion, and I'd really like to be able to convert that passion into an educated understanding. Not to share my political opinion, but just to understand how the industry works. I'll put my credentials in this space up against anyone- and by anyone, I really mean ANYONE- not trying to boast, just trying to make clear (without posting my resume) that I know what I'm talking about- AND i do not work for Blues of ND

Thanks Mate. The industry is hard to understand for most people, because it is a mystery of things like coding, actuarial science, and benefits that historically were designed to deter utilization or cost shift to employees. The other HUGE thing to remember with that maximum 15% gross margin is that I have to fund investment in the future and also (because we are talking fully insured) insulate myself from catastrophic claims. If they price too high, they won't sell policies in a competitive environment. If they price too low, they will not sufficiently manage the risk of high cost claims. In fact, any surplus (called risk based capital) is often a set large amount required by regulators to ensure the viability of the system in a crisis where no premiums are coming in, but people need services (read: pandemic or gov shutdown or depression) The question regarding % vs actual margin- it has to be %. Investors think about %.

9 year old is a freaking squirt...no way... Bantam is when I've seen real scouting happening, and usually for junior. Then junior and high school for college and pro.

Not the same way they don't. Not in the metro anyway.

That is fully insured only remember, self-insured has a margin of 2-5% and makes up more of most plans block in terms of %. This level of gross margin is among the lowest in all industry. Retail for example works in a 40% gross margin environment- minimum. Providers won't allow for a pooling of resources. It creates too much leverage and would reduce their reimbursement. I have been a consultant in this space- not with BCND, but with some national plans. It is not a panacea. If I had unlimited capital, health insurance would be the last industry I would want to go into.

I guess physicians, nurses, actuaries and other professionals are clerks... This is the most misunderstood industry on the planet, because most people have no comprehension of what goes on. Without the insurance company, you would pay MORE for healthcare or lose access to high value healthcare.

Love it! Go Farce, Go Sioux

Extremely unlikely that a non-top 16 pairwise winner will come out of the Hockey East or Big 10 conferences. It is a lock for Atlantic Hockey It is possible for NCHC and for WCHA and ECAC I would say that top 12/13 in PWR is safe. Now are we safely secured in 12/13? Not yet...getting closer...a sweep of western should just about do it.

MEDICAL LOSS RATIO...do you know what that means? It means that the money paid out as claims has to be no less than 85 percent of premium collected. With that remaining 15% you have to cover your costs...pretty slim gross margins. 15% pays salaries, real estate costs, customer service, provider and medical management... THEN...the self insured component. Most business is self-insured. You make no money there...it is simply admin fees which are very price competitive. Actually- medicare is about the only aspect of health insurance that is profitable for a commercial insurer. It isn't that hard- there is no money in health insurance any more.

Agree that it isn't the motivation. Historically, conferences have been based on geography, so by trying to fill seats, you will likely end up with the result. So, unintended consequences.

If I were cloud I'd go black...keep us out of the business suits

...if it ain't broke...

Johnson and LaDue are locks for all rookie team Thompson and Stecher will warrant consideration Goth berg and Simpson are locks on conference honors Schmaltz, parks, and Rocco will warrant consideration Nicely done boys- rookies doing great, which is the correlation back to this thread. Also- who'd have thought Tambellini and Murphy not in lineup...

Home team makes the call on alternate jerseys

Time to put the women and children to bed. Win a trophy tonight. Beer tastes better and the girls get prettier when you win.

They had a bad line change that led to an oddman and a goal. 2 other goals were mirror images of each other with a good, low, hard shot to the far side, then our winger beat the dman to the rebound. Looked more like Gaarder and MacMillan simply outskated the d on the weak side...drive the far post with your stick on the ice, use your speed to get body position...text book winger play.

That bulldog team had a stacked top line and pp. we need our pp to start firing now. 5x5 is looking good...NCAAs have a tendency to be special team fests. We need to fire on the pp and prepare to handle the tv stoppages. We appear to be a lock for the tourney now. First things first....business suits and the inaugural Penrose sounds pretty good to me!

WCHA used to be head to head first. NCHC the first tie-breaker is conference wins. They did this due to the new tie and shoot out point rules.

Can't see from tv why interstellar going wide

UND playing solid. Easy pp goal for clown. Good hockey game

Too smart for that! Go SIoux!