#insurance

How long you all been with the company? Does layoffs usually affect claims too? I see they still have many openings and currently doing layoffs?

By any chance, has anyone noticed any announcements recently about new programs being offered to Fidelity employees starting in 2027? IN PARTICULAR, insurance products from Farmers Insurance?

Hello all. Can you share some information about working at Costco. What is the healthcare insurance plan from Costco covered and monthly premium?

GEICO has announced job cuts impacting its Florida operations. The insurance company is reducing its workforce by 114 positions. These layoffs specifically affect the personal injury protection division. The affected employees are located in Florida. This action comes as part of a broader operational adjustment.

Tampa, Florida

https://www.bizjournals.com/tampabay/news/2026/11/02/geico-plans-layoffs-in-lakeland-legal.html

Source below…

• Operator: Thank you for calling the FBI. Can I have a spelling of your first and last name please?
• Caller: First name is J, O, S, E. Last name is C, A, Z, A, R, E, Z.
• Operator: Thank you for that. Date of birth you provided was 8:31. You're reporting to the FBI today.
• Caller: So I like to report a, I guess national security threat by the CEO of State Farm, John Furneau.
• Operator: National security threat by the CEO of State Farm. What exactly is he doing?
• Caller: Not his job apparently if I'm over here calling you. I've been having non stop issues with this company. Um, so pretty much in the beginning of the year around January 31st, I got into a car collision of, via attempted mu---r and with State Farm over like a 3,000 dollar repair. They falsified the records to up the value to 9,000 totally my vehicle. And then afterwards I called my handler like multiple times.
• Operator: Oh, sorry, sir. Sorry, what, sir? At this time, contact an attorney. Thank you for calling.

https://www.tiktok.com/@josecazarez777/video/7696954572769742094

I really feel like the higher ups understand us workers and have heard us. They get it and are here for us. Thats why I think its great during this time of huge profits they increased the insurance premiums over 20% to let us know how much we are valued. Oh and on top of it higher deductibles /out of pocket costs. Thank you marathon you are the best.

Sincere Post Here to Hopefully Help Others Make a Decision for Medicare*

• This is coming from someone with many years experience in the health insurance business and also is aware of how the super polished advertisements you see on TV by the main health insurance payers and eHealth dotcom, which push Medicare Advantage. Spoiler: This unpaid “Commercial” is for Traditional Medicare with Medigap Plan.

3 False Narratives:

Proponents for MA will:
1: Try to convince you that they have large provider networks to ensure your claims get approved.

REFUTE:
However, many provider groups have chosen to no longer contract with Medicare Advantage due to the slowness of payers to pay them and also the many hoops the providers have to jump through. Also, many Provider Directories are out of date and there is constant movement.

Short of it is, if you sign up again with Medicare Advantage, you might receive a “surprise” bill in the mail that your health services were provided by someone no longer in their network.

But with Traditional Medicare with a Medigap Plan you do not have to worry about any such “surprises.” Because in essence every licensed provider is considered in-network, so to speak.

Proponents for MA will:
2: Erroneously contrast themselves against Traditional Medicare with the dental, optical, aspect and also bait you in with “everything is rolled up into one neat package” speel and also offer you all kinds of extraneous stuff like free gym memberships, free grocery debit card, etc.

REFUTE:
First of all, purchasing dental and optical insurance separately is not terribly expensive nor difficult. And it is not difficult to sign you up for Traditional Medicare and to purchase you a Medigap plan, without needing to undergo underwriting if your MA plan was terminated at no fault of your own.

As to free gym memberships and free grocery debit cards, those are niceties but true purpose of health insurance is covering any expensive unexpected health claims covered. Think unexpected catastrophic things such as Cancer, Cardiovascular Issues, Organ Transplants, Rare Diseases, Knee Replacements, Diabetes, etc. Will for-profit health insurance have your health outcomes in mind or their profits? And I assume you don’t want any surprise bills that could bankrupt you.

eHealth dotcom, will:
3: Tell you that they are paid by the health insurance corporations to compare and offer their plans, which is true. However…

REFUTE:
EHealth completely omits mentioning Traditional Medicare and does not offer any comparison nor offer assistance to switch over to Traditional Medicare with a Medigap plan. They are financially biased towards MA plans.

Disclaimer: I am not a licensed agent for Medicare. These are my own personal opinions. Please make decisions for what plan works best for you.

Traditional Medicare with Medigap Plan
https://www.medicare.gov/providers-services/original-medicare

how are the new health plans? how much ELfu-kO sc--wing us this year? is that "surest" plan just using our medical records to train AI?

Happy open enrollment day! Good news: your deductible has increased from $2,000 to $3,000! Your groceries and gas are still at an all time high, while raises have not kept up with inflation, and now Waters has negotiated insurance that sc--ws up with your finances again! Just couple years ago the deductible was $1,500.

https://www.ft.com/content/5495d88b-b457-498a-bedd-64a954b538cd

What is everyone else seeing? Do they folks who are on the fence will now leave? This is definitely a sign for US employees. Dental and vision no change, but they are small cost. Voluntary life insurance up 70%, using same criteria as 2026.

Am I crazy or did rates go way up? I know the switch from bi-weekly to semimonthly adds a bit, but I’m seeing the cheapest option for the employee only HSA Plan in the low 90’s. I currently pay just under 50 for my medical premium. Unless I’m reading something wrong, that’s about a 70% increase year over year.

WTF

This is strange. Anyone knows why? Right now all the family's premium is before tax money. In 2027 the premium for spouse or for kids has become AFTER tax money, which is effectively an increase.

Has the bloated little bank’s bubble popped?
Does leadership know what the yield curve is?
Has all its impressive PowerPoint divisions performed like its peers?
Does it know its mission statement? Are its employees its greatest asset?
If so where is the performance little bank with big boy pay and big dreams?
Stadium naming or shareholders?
Intellect and leading edge technology to eliminate wastes like HR, Benefits, Payroll, Insurance and Enterprise Risk.
Pittsburgh unionized or profitable and cutting edge.
Comes down to the top

Insurance being sold off for $2.4billion.

Wonder if the Execs will take cuts running a smaller ship. The lucky folks will be off loading to another company and will get be getting pay rises.

Any news on upcoming health insurance rate hikes ?

What am I missing?

and that's just medical!
How many of us are going to get a raise that covers that!
What a pathetic company.
100% agreed and confirmed. Opentext Execs are a bunch of aholes

For health insurance corporations looking for a turnkey product to calculate health provider settlements, the selection depends on whether you are analyzing fee-for-service (FFS) reimbursement contracts, processing complex bulk provider payments, or needing a data extraction layer for your core adjudication system.
The industry's leading turnkey software options specialized for health plan/payer settlement calculations include:

1. Milliman Dynamic Reimbursement Modeler (DRM)
   The Milliman Dynamic Reimbursement Modeler is a highly specialized turnkey solution built precisely for healthcare provider reimbursement negotiations, calculations, and contract management.

• Best For: Payer-provider contract settlement modeling, reimbursement parity analysis, and fee-for-service contract calculations.
• Key Capabilities: It allows health insurance corporations to input complex reimbursement terms alongside claims data to assign expected payments, reduce manual workflow errors, and provide audit-ready traceability documentation.

1. PLEXIS Healthcare Systems (Quantum Choice)
   PLEXIS Healthcare Systems provides turnkey financial administration and revenue reconciliation platforms tailored for commercial health insurance corporations, Medicaid, and Medicare Advantage plans.

• Best For: Core claim administration, daily provider payment settlement processing, and complex multi-payer revenue reconciliation.
• Key Capabilities: It modernizes back-office financial administration without forcing a total core business model replacement, streamlining the operational math behind multi-facility provider settlements.

1. Comarch Insurance Claims
   Comarch Insurance Claims is an end-to-end, API-ready software platform engineered specifically for health and life insurance carriers.

• Best For: High-volume digital health claims calculation and rapid automated provider payouts.
• Key Capabilities: Focuses heavily on lowering operational costs via automated decision-making and seamless integrations into existing payer ecosystems.

1. Regure (Claims Automation & Adjudication Feed)
   For health corporations utilizing legacy core platforms (such as TriZetto Facets, QNXT, or HealthRules Payer), Regure Health Claims Automation acts as a turnkey data layer.

• Best For: Modernizing settlement workflows by feeding clean, structured data into core adjudication engines.
• Key Capabilities: Features bi-directional integration that automatically moves adjudicated payouts, denials, and calculated provider settlement figures back into communications and audit trails, removing manual data entries from the calculation loop.

Can we opt out of the insurance when we get the VSP?

I guess they will have the insureds take photo themself and send them in.

I am thinking that much like the way AI was recently renamed SI, which as an aside I think there is nothing Super about it. It is totally Artificial “intelligence.”

Anyway, just like we renamed that, because there is not much interest in these so called “Health” Insurance corporation’s Executives in actually insuring their member’s health, perhaps we should consider renaming “Health” Insurance to something like
Profit Insurance
Or maybe
C-Suite Executive Insurance
Or maybe
Shareholder Insurance
Or maybe
Corporate Government Fund Free Insurance

And as for Medi”care” “Advantage” maybe we should consider renaming it something like
Medi-Deny Disadvantage
Or maybe
Medi-Delay Disadvantage
Or maybe
Medi-Free-Draw-You-in-Perks-But-No-Real-Substantial-Coverage Disadvantage

If you can think of some better names, please feel free to add them in the comments below.

This is a FYI for former employees - I have Anthem BCBS so may not apply to everyone. Went to Dr and went to pick up scripts both showed that I was not eligible. Checked insurance portal and showed I was active. Called today and shocker Centene dropped the ball. They were supposed to send files of impacted employees weeks ago but failed to do so. Anthem received all at once and was scrambling to upload in their system. So there may be a delay in eligibility. I was instructed to let my providers know to submit the claim and Anthem will pay. This entire program rolled about by Centene has been a sh-tshow. I worked for the company for 22 years and simply reduced to a number based on an algorithm. It is sad to see the shift under SL. MFN would have never allowed this to happen or if there was no choice there would have been a more thoughtful choice. For those still there it will happen again. This company had no heart it has been reduced to a cold soul su-king environment.

Verizon used to be known for good health insurance but now Dan has gone and ruined it seems. Prices going up and benefits being reduced. Crazy

Insurers say AI could add billions in health costs. Billing companies disagree
https://www.healthcaredive.com/news/insurers-say-ai-could-add-billions-in-health-costs-billing-companies-disag/831497/

Hospital trade group pushes back on report linking ai to $942m in added health costs
LinkedIn · Prachi Sahoo60+ reactions · 1 week agoThe $942 Million Question: Did AI Make Hospital Billing More Honest, or Just ...

Therefore, it is critical that we find a way to breakdown the Monopolistic Predatory Abuse of the 5 Major Private Health Insurance Corporations (e.g., Humana, United, Elevance/Anthem, Cigna, Centene) that use Government Funded (Tax Payer) Dollars to continuously delay and deny legitimate lifesaving healthcare to the elderly, disabled, and indigent on Medicare Advantage plans.

The CMS released draft star ratings, including the thresholds for reaching those ratings, to plans earlier this week. The grading sheet got stricter, which doesn’t bode well for insurers.

Entire Article Regarding the above Teaser
https://www.healthcaredive.com/news/medicare-advantage-stars-cutpoints-2027-cms/829963/

CMS Facts Sheet for 2027
https://www.cms.gov/files/document/2027-medicare-advantage-part-d-landscape-state-state-fact-sheets.pdf

So, I guess CareFirst thinks they are going to further price-gouge their members to try and fix their upper management/CEO financial incompetencies/mistakes. Just got my medical policy renewal on the exchange for 2027, and it increased by 18%. They are just going to lose more members with this asinine move -- including this member. I will NOT be renewing. Good luck, CareFirst. You best start asking somebody for your bailout now. You're not coming back from this one.

Hello! I had the same issue as others where the subsidy was not showing. Finally, it updated with Optum and I made the first payment last week. I just got a message from my provider saying my insurance is inactive and I will have to pay out-of-pocket. I had already reached OOP max for the year and should be paying nothing. Does anyone know?

I have not received anything in the mail or via email about my COBRA benefits. I need a copy of it so that my spouse can see if they can add me on their insurance due to lose of coverage before I do COBRA. Can someome please help me? Should I use another form or call HR to request a letter? I also would like to know how much my COBRA would be if this doesnt work out. I logged into the Optum Financial website and I see nothing!

• Cigna Group emailed its US employees to say its health plan would stop paying for GLP-1 medications for weight loss, prompting an outcry from employees.
• A growing number of employers are looking to limit coverage of GLP-1s to cut expenses, as employee health-benefit costs are expected to climb and prescription dr-gs are one of the main reasons.
• Some companies that continue to cover GLP-1s are creating friction within the company, as some workers who don't use them question whether the added cost will drive up premiums for everyone.

https://www.bloomberg.com/news/articles/2026-09-23/pepsi-starbucks-cigna-among-companies-dropping-glp-1-insurance-benefits

The benefits were the reason people have stayed and powered through fidelity. Now with united healthcare and delta dental… this is the real attrition strategy. Both companies su-k so bad and my doctors and billing hate UHC. They have monologued me more than once for having sh---y insurance

is mental health data from insurance reaching HR (albeit in a way to "hide" names)??

What else is next? Health insurance is too expensive already!

Has anyone received anything from Hartford Connecticut in regards to converting or porting Life Insurance options as stated on the VSP?

Time to put my skills to work for good instead of evil.

I just wonder how the executives in the health insurance industry sleep at night? When your day consists of:
“How can we turn a bigger profit from the tax money that’s supposed to go to the poor starving sick people?”

Can we stay on insurance for 6-12 months after the termination date? Is this negotiable with HR?

Could anyone clarify whether we are required to pay the initial premium amount sent by Optum, which reflects the total before the subsidy is applied? I was advised by CNC HR that we must pay the full amount upfront and that Optum will later deduct the subsidy once they receive the relevant details, warning that failure to do so could result in the termination of our insurance on 9/30/26 without the possibility of retroactivity. However, Optum has provided conflicting information. Does anyone have definitive guidance on the correct procedure, as I am hesitant to pay $3,000 upfront to prevent my insurance from being cancelled?

Isn’t it ironic that a health insurance corporation fails to provide the best health insurance coverage for its employees?

Found this gem in one of the older threads and I didn't know if I should laugh or cry. This is 100% correct. We're supposed to have the best coverage considering where we work and we're so far away from it that it's a joke.