Daily Archives: February 6, 2018

Blue Cross Blue Shield SC addresses Opioid Epidemic

From Blue Cross on February 1:

As our state and nation mobilize to address the opioid abuse epidemic, BlueCross BlueShield of South Carolina is committed to doing its part. Starting April 1, 2018, new limits on opioid prescriptions will take effect for all employer groups with BlueCross pharmacy benefits.

We work with an independent panel of BlueCross network physicians and pharmacists, the Pharmacy and Therapeutics Committee, to develop and maintain our drug lists and policies. Clinical decisions are based on drugs’ efficacy, safety and value, with the goal of providing the greatest clinical effectiveness for the lowest cost.

Addressing opioid prescriptions specifically, the committee has focused on daily quantity limits and added requirements for prior authorization in some prescribing situations, basing its decisions on guidance from the federal Centers for Disease Control and Prevention.

According to the CDC, there were a record 33,000 U.S. deaths from opioid overdoses in 2015 — nearly half of them involving prescription medications. In 2016, nearly 5 million opioid prescriptions were filled in South Carolina, according to the S.C. Department of Health and Environmental Control.

“There is evidence that the more opioids are prescribed in a given region, the more likely it is that there will be a related increase in addiction and in overdose deaths,” said Dr. Matthew Bartels, BlueCross vice president and chief medical officer. “As this epidemic is addressed at the federal, state and local levels, we are hopeful that our new Opioid Management program will be part of the solution in South Carolina.”

Employers will not be able to opt out of the program. However, patients who have sickle cell disease, are undergoing cancer treatment, or are receiving palliative care or end-of-life care, will be exempt from the program requirements.

For details, please see this Update Bulletin on opioids from our Pharmacy Management department.

Attached to the policy bulletin about opioids is the regular Pharmacy Management Update Bulletin outlining some other drug list revisions. In particular, please note the coverage update affecting medications used to treat hepatitis C.

Oscar and Axa team up

From Oscar Health Plans on February 1:

There’s been a lot of attention and excitement in the industry, and we’re happy to be a part of it.

First, I’m excited to share that Oscar has recently partnered with multinational insurer AXA! It’s a great indicator of Oscar’s solid financials, and we’re excited to continue to grow.

You can learn more by reading about it here, or by following along in the notes below:

Why did Oscar pursue a quota share deal with AXA?

  • All health insurers are required to hold a certain percentage of its premiums as “reserves” so that regulators can ensure that carriers have enough money to pay their future claims.
  • With the AXA deal, Oscar will cede 50% of it’s premiums/claims to AXA, which will free up 50% of its capital requirements
  • We expect that the deal will free up nearly $100 million in capital over the next few years, providing capital relief as we continue to grow

I’m also thrilled to report that we’ve enrolled over 250k members across six states, and expect to generate $1 billion in revenue in 2018. Learn more below:

We’re grateful to have you as a partner during this exciting time of growth at Oscar. If you’ve written Oscar business and haven’t yet filled out our survey, please click the link. Five minutes of feedback could make a big difference!

Louis DeStefano
National VP of Sales
Oscar Health

What, exactly, is MediShare?

Maybe you have been considering joining Medi-Share for health insurance since you cannot afford the crazy premiums these days.   There is a good Article in Politico about the background on these plans.  One thing to remember on these plans is they are not health insurance, not monitored by the insurance departments, and there is no complaint tracking.  Caveat Emptor.


Managing Student Loan Debt


 A review of some options for federal and private loans.


Provided by Reeve Conover


Are you dealing with student loan debt? Have you explored ways to try and restructure it or have it forgiven?


No one wants to carry five figures of education debt into middle age or retirement, but some do. The burden is not just financial. Last fall, the Madison Capital Times asked student loan borrowers in the state of Wisconsin how they felt about their education debt. Sixteen percent said they were “terrified” of it, and another 30% indicated they felt only slightly less so. Fortunately, you may have possibilities to manage and reduce the debt load and the anxiety it breeds.1


For a better chance of refinancing a student loan, lift your credit score. The average credit score for borrowers able to refi in 2017 was 764, according to online education loan marketplace LendEDU. A 764 score means you have excellent credit; 850 is as high as you can go, and 700 is considered an “average” FICO score. If you are offered new terms, you may or may not like them; LendEDU says that the average interest rate on a newly refinanced loan last year was 5.56%.2


It is hard to arrange new terms of payment; LendEDU reports that more than half of student loan borrowers who applied for a refi in 2017 were turned down. Some borrowers reject the refinancing offers they get. In about 25% of states, you can also approach state refinance authorities, which tend to set the bar lower for qualifying credit scores. Keep in mind that if you refinance a federal loan, you may lose eligibility for an income-driven repayment plan that limits your monthly payment to 10-20% of your discretionary income.2,3


If refinancing is not possible, consider both common and unusual financial options. You could find a new job, one at which you can negotiate a higher salary than you now earn (in this economy, that might not be so difficult). Ask for a raise from your current employer. Sell things or freelance as a path to generating extra cash you can apply to your loans. Alternately, find the cash through frugality. Go car free, room with someone, sublet your apartment, or downsize to a less expensive residence. Think outside the box: would it be cheaper, better, and more fun to live in another country? Could you get a job that pays your rent for you?


Can your loan be forgiven? The channel the federal government offers toward student loan forgiveness is not for everyone. The Public Service Loan Forgiveness (PSLF) program asks you to work for a non-profit, in a public service capacity, for ten years. Some borrowers look at those conditions and see career and salary compromises they are unwilling to make.4

If you have no interest in working in the non-profit sector, there are possible paths toward federal student loan forgiveness apart from the PSLF. Some states have their own payment assistance programs, some of which require less than five years of work for eligibility. Sometimes the assistance depends on the borrower moving to a rural community within the state or pursuing a STEM, medical, or educational career.4

Can you go to work for a big company? If you do, your employer might be willing to help. A small percentage of corporations are matching the student loan payments their employees make. Others are offering workers $1,200-$2,000 a year to apply toward repayments.4


Those who serve in the Army, Navy, Air Force, and National Guard can potentially take advantage of student loan forgiveness programs within those service branches. The Army’s Student Loan Repayment Program (SLRP) can put as much as $65,000 toward repayment of an active-duty soldier’s education loans. Veterans may also find themselves eligible for these programs.4

Teachers can also pursue Teacher Loan Forgiveness (TLF). Through this federal program, you can arrange to have as much as $17,500 in federal education loans waived once you have taught math or science for five years at the high school level or special education classes for five years at any grade level. You must work for an educational services agency or teach at a school where students are primarily low income to be eligible for TLF.4


There is one inescapable fact about all this: eradicating student loan debt takes time. You may live with that debt for a decade or longer; the good news is, you can save, invest, and plan to build wealth even while carrying such debt. Be sure to talk with a financial professional about that possibility.


Reeve Conover can be reached at reeve@reeevewillknow.com, or 843-800-8190


This material was prepared by MarketingPro, Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment.





1 – tinyurl.com/y72vtnp2 [1/8/18]

2 – time.com/money/5104919/average-credit-score-student-loan-refinancing/ [1/17/18]

3 – studentloanhero.com/featured/strategies-broke-cant-pay-your-student-loans/ [6/22/17]

4 – forbes.com/sites/andrewjosuweit/2018/01/31/5-ways-you-can-get-student-loan-forgiveness-that-dont-involve-public-service/ [1/31/18]

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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