Important industry news brought to you by Sacramento Association of Health Underwriters (SAHU).

The Centers for Medicare & Medicaid Services (CMS) revealed on Thursday, August 31^st 2023, that the initial group of ten Medicare Part D medications slated for negotiation under the Inflation Reduction Act (IRA) has been identified.

These drugs have been designated based on the outlined criteria within the IRA. This legislation mandates that CMS prioritize drugs with the highest Medicare expenditure and minimal competition, among other considerations. The resulting roster encompasses medications that are crucial for numerous Medicare recipients in treating various conditions such as cancer, diabetes, blood clotting, heart failure, autoimmune disorders, and chronic kidney disease.

Negotiations regarding pricing will commence this year between CMS and the participating pharmaceutical manufacturers. Finalized prices will be disclosed next autumn by CMS, with implementation set for 2026. In the ensuing years, additional medicines will be included for negotiation.

Projected Benefits for Beneficiaries and Medicare

In 2022, the U.S. Department of Health and Human Services (HHS) approximated that the expenses for the chosen ten drugs totaled $3.4 billion in out-of-pocket payments for Medicare beneficiaries. While the specific savings for individual beneficiaries through the IRA’s negotiation initiative will be contingent on the forthcoming reductions in prices, overall reduced costs are anticipated across the board. It is noteworthy that the Congressional Budget Office (CBO) predicts that these negotiations could save Medicare a total of $98.5 billion over a ten-year span, subsequently leading to decreased financial burdens for beneficiaries and taxpayers. Importantly, this law will achieve these outcomes while simultaneously enhancing health results and program stability. The CBO underscores that the lowered drug costs will encourage better adherence to prescribed medications, ultimately enhancing beneficiary well-being and diminishing the necessity for more expensive medical care covered by Medicare.

Furthermore, complementary reforms tied to the IRA are either already in effect or will soon be implemented, further enhancing the affordability and accessibility for beneficiaries. Several key measures are already active, such as capping monthly insulin prescription costs at $35, providing no-cost Part D vaccines, and reducing coinsurance for certain Part B drugs. In the upcoming year, an increased number of Medicare beneficiaries will experience relief as the IRA abolishes enrollee expenditures in the Part D catastrophic phase and extends full Part D Low Income Subsidy (LIS) coverage to individuals with incomes equal to or less than 150% of the poverty threshold. By 2025, the legislation will also impose a limit of $2,000 per year on beneficiary Part D drug expenses and allow beneficiaries to pay these costs in more predictable monthly installments, offering vital financial security.

Previous estimates from HHS indicated that the Part D changes brought about by the IRA would save a minimum of $400 for one out of every three enrollees in 2025. Notably, a considerable number of beneficiaries will experience even more substantial savings: over eight million will witness a $759 reduction, and nearly two million will benefit from a $2,500 decrease, reflecting a 66% reduction relative to their present costs. Once the negotiation program is initiated in 2026, these savings are expected to expand further.

Engaging the Public

This initiative encompasses ten virtual public Listening Sessions set to take place in the upcoming fall, with each session focusing on one of the selected drugs. The agency has stated that this series will “offer an avenue for patients, beneficiaries, caregivers, consumer and patient organizations, and other interested parties to provide input relevant to the drugs chosen for the initial round of negotiations.” Stakeholders are required to pre-register for the opportunity to make live, public statements.

“It’s important for insurance agents to educate their clients about the impact of the Inflation Reduction Act this year more than ever.” Rosamaria Marrujo, past SAHU president and incoming CAHIP president.

Additionally, CMS will accept written statements from September 1 to October 2, 2023. Further details about how to contribute to CMS concerning the negotiation process can be found here
https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation

For More Information:
To access the CMS announcement, click here.

For a comprehensive fact sheet from CMS about the drugs selected for the Medicare Drug Price Negotiation Program, along with additional details about patient-focused listening sessions, please visit this link.
https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf

For further information about the upcoming listening sessions and the opportunity for written comments, refer to this resource.
https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation-program-patient-focused-listening-sessions

For in-depth insights into the Medicare Drug Price Negotiation Program, explore further here.
https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com. 

The Sacramento Association of Health Underwriters (SAHU) is proud to announce its esteemed board members for the 2023-24 term, showcasing a diverse and dedicated group of professionals committed to advancing the goals and mission of the organization.

Board Members and their Roles:

Helen Ornellas
President

David Brabender
President-Elect

Rosamaria Marrujo
Past-President

Jacqueline Martinez
Treasurer

Lauren Bayha
Executive Director

Michele Mills
Secretary

Michele Meder
Awards Chair

Tamara Moreau
Carrier Relations

Brad Wright
Legislation Co-Chair

Telly Tasakos
Membership Retention Chair

Adam Aguilar
Professional Development Chair

Cerrina Jensen
Political Action Committee Chair

Andrew Garnett
Community Services Chair

Kyle Frantz
Communications Chair

Antonette Vanasek
Media Relations Chair

Dave Fear Jr.
Legislative Co-Chair

Danny Langarica
Vanguard Chair

Angie Caruso
New Membership Chair

Andy Glenn
Programs Chair

Renée Balcom
Diversity, Equity, and Inclusion Chair

Dalia Sutton
Medicare Chair

Our Mission and Vision for the 2023-2024 Term

President Helen Ornellas shares her vision for the year, stating, “Our mission in 2023-2024 is mentorship and leadership.  SAHU is looking for those who would like to make a difference in our chapter, in the industry, and their careers. We have started the Past Presidential Advisory Committee to provide insight, one on one mentorship, and guidance for those who are interested in leadership at the Chapter Level, State Level and National. Or lets us know how we can help you; we have the tools and people! 35 Years strong.”

SAHU Board Nominations

Joining the SAHU board can provide a wide range of benefits for both personal and professional growth. By becoming a board member, you can expand your network and connect with other industry professionals.  Additionally, you can have a direct impact on the strategic direction and decision-making processes of the association. Serving on the board can also enhance your leadership and teamwork skills, as you work collaboratively with other members to achieve common goals.  It’s an opportunity to give back to the community and make a positive impact on the industry, while also gaining valuable experience and building your resume.

Perhaps you or someone with whom you have served has the vision and the passion, both for the association and for the industry as a whole, to help lead SAHU in the coming years.

 To nominate a deserving candidate or even yourself, please visit https://sahu-ca.com/sahu-officers-nomination-form/.  The deadline for nominations is April 15, 2024.

Let us work together to build a stronger, more vibrant SAHU community.

2023-2024 SAHU Board Members Induction

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com. 

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SACRAMENTO, CA – Jun 30^th 2023 – The Sacramento Association for Health Underwriters (SAHU) would like to extend its gratitude to all its dedicated members who actively participated in NABIP’s Operation Shout to oppose SB 770, a bill aimed at financing a state-run health care system in California.

Despite the tremendous efforts and numerous communications from CAHIP members, SB 770, which seeks to advance Single Payer Health Care system in California, has successfully passed the Assembly Health Committee and is now progressing to the Assembly Appropriations Committee.

If enacted, legislation would establish a workgroup with the goal of petitioning the federal government to redirect significant funding, potentially amounting to hundreds of billions of dollars, from Medicare and Medi-Cal.  The intention behind this redirection would be to support the implementation of a state-run health care system, which has yet to undergo comprehensive testing, including an assessment of its potential costliness.

SAHU kindly urges all its members and non-members to take the time to review the details of SB 770. You can find the fully written Bill here: https://leginfo.legislature.ca.gov/faces/home.xhtml

We encourage you to talk to your Assemblymember about the potential implications it may have.  If you would like to join SAHU in expressing opposition, we invite you to visit the following link https://nabip.quorum.us/campaign/48542 and participate in Operation Shout. Your voice holds significance, and your participation can potentially contribute to the outcome of this bill.

If you are not a member of SAHU, click here- https://sahu-ca.com/benefits to learn more about our great organization and how you can join.

If you are interested in supporting our PAC contribution, click here: https://www.efundraisingconnections.com/c/CAHUPAC/

In the coming weeks, SAHU will diligently provide updates on the progress of SB 770 in the Assembly Appropriations Committee. We assure you that we will keep you informed of any developments as soon as the information becomes available, with the latest update expected no later than September 1, 2023.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com. 

SACRAMENTO, CA- May 8-10^th 2023 – Members of SAHU (Sacramento Association of Health Underwriters) attended the annual Capitol Summit held by California Agents & Health Insurance Professionals (CAHIP), reporting back a warning against the implementation of a state-run health care system.  

SAHU strongly opposes – SB 770: a proposed legislation that would create a costly and untested state-run health care system.  SAHU emphasizes that implementing SB 770 would eliminate existing Medicare and Medi-Cal programs, leaving millions of Californians without essential health care coverage.   SAHU warns that SB 770 does not introduce new providers or facilities, potentially leading to longer wait times for procedures, reduced access to specialists, and a loss of doctors to other states. The association urges the Legislature to pursue constructive and viable solutions to enhance access to affordable health care.

SB 770 is the first step towards a single-payer health care system, which not only eliminates Medicare and Medi-Cal but also prohibits private health coverage, including employer-sponsored plans. The projected cost of over $500 billion per year would require significant tax increases on individuals, employers, and small businesses.

CAHIP states in its own talking points of this year’s Summit, that there has been “progress made in expanding access to affordable health coverage in California since the passage of the Affordable Care Act. Californians are satisfied with their health care and prefer to build upon this progress, preserving their ability to choose private coverage for their families.” 

To read more about CAHIP’s Capitol Summit talking points, visit their website- https://www.cahu.org/cahip-capitol-summit-talking-points.

SAHU Supports AB 716: Protecting Californians from Costly Surprise Billing for Ambulance Services.  SAHU stands behind AB 716, a vital legislative measure aimed at safeguarding injured Californians from burdensome balance bills and resolving billing disputes for emergency ground ambulance services beyond their control. 

By passing AB 716, Californians will be protected from excessive out-of-pocket expenses and relieved from the complexities of billing disputes between health plans and ground ambulance service providers. This legislation is crucial in addressing the common practice of surprise billing, or “balance billing,” which often leaves injured individuals in the midst of billing disputes for essential services.

ON WATCH– SAHU is also closely monitoring AB 1690, a “spot bill” lacking substance and a funding source for a proposed government monopoly on health care.  SAHU advocates for market stabilization strategies and supports AB 716, which aims to protect Californians from expensive balance billing for emergency services.

Dave Fear Jr., SAHU Legislative chair says this, “Addressing our elected legislators, whether in DC or Sacramento, is such an important part of our governmental system. Being able to meet face to face and let them know who we are, what we do and how we work to make things better is a fundamental part of citizenship in this country!”  SAHU maintains a steadfast commitment to actively engage and participate in relevant legislative proceedings and keeping the public informed with accurate information. 

If you are interested in learning more about current health insurance industry news and legislative updates, please visit our website, https://sahu-ca.com.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com. 

Sacramento, CA – On March 31st, 2023, the Sacramento Association of Health Underwriters (SAHU) hosted its Annual Crab Feed, a highly anticipated event that drew in a crowd of 380 attendees, all gathered to enjoy 1,000 lbs. of crab, 120 lbs. of shrimp, and a variety of delectable desserts.

SAHU’s Annual Crab Feed was a tremendous success, thanks to the hard work and dedication of the organizers and the generous support of the attendees. The event was held to support a worthy cause, the American Cancer Society, and the attendees’ contributions raised an astounding $20,000 to aid in cancer research and support services.

The evening was filled with exciting activities, including a silent auction, where 68 auction items were sold, and 10 items were generously donated. The event’s attendees also had a sweet tooth, as 23 desserts were donated and sold at the event.

“{insert quote},” said [Name], President of SAHU. “We are incredibly grateful for the support and contributions from our attendees, which enabled us to raise $20,000 for the American Cancer Society. It’s truly heartwarming to see how our community comes together to support a worthy cause, and we can’t thank our attendees enough.”

SAHU’s Annual Crab Feed is a significant event for the community, bringing together members of the Sacramento community to support a worthy cause while enjoying a delicious meal and engaging in fun activities. SAHU is committed to continuing its efforts to support the community and make a positive impact.

For more information on SAHU and its efforts, please visit their website at sahu-ca.com.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com.

WHO:  Ellevate Foundation WHAT:   2-day Women’s Leadership Summit providing tools and resources to grow personally and professionally WHEN:  March 13th – 15th   WHERE:  JW Marriot Resort & Spa – Las Vegas, NV WHY: The Leadership Summit provides an opportunity for both current and aspiring female leaders in business to advance their career, personal growth, and increase impact and support in their teams as well as their industry. Sacramento Association of Health Underwriters (SAHU) is honored to invite you to this Leadership Summit and proud to support our very own Cerrina Jensen, Ellevate Co-Founder and PAC chair who states, “Given that only 23% of executive leaders in our industry are women, but we make up 67% of entry level staff, Ellevate Foundation believes this annual leadership summit is a timely and critical opportunity to help bridge the gap and fast track both current and aspiring female leaders as their careers unfold.”     To find out more information on the guest speakers, workshops, registration and more, please visit their website- https://www.ellevatefoundation.org.  You may also contact them directly by email hello@ellevatefoundation.org.   You may also visit the SAHU website https://sahu-ca.com/event/ellevate-womens-leadership-summit-2023/           ###   For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com