Cigna Mckinsey: Fill & Download for Free

Yes.The quality of traditional benefits is exceptionally high at McKinsey & Company.The healthcare coverage is unmatched, because McKinsey pays for everything itself (self insures) and just has Cigna process the payments for a fee. So there are no "in-network" or "out-of-network" doctors or hospitals. Almost everything is covered 100 percent with no deductible or copay. And they offer a free annual executive health checkup. The dental care is also very good and provides more cleanings than most plans.McKinsey can afford this because the workforce is very young and healthy to begin with. There's mandatory retirement for partners at age 55. Most of the employees are in their 20s or early 30s, and most people leave within 3 years.The retirement plan is also exceptional. The fees are very low and the performance is very, very good.Other notable benefits include lots of snacks and drinks in the office, a concierge service (you pay extra for this if you use it), and excellent training programs in exotic and fun locations like Kitzbuhel Austria and Singapore.You can learn a lot more about McKinsey at Askapeer.com, which routinely has interactive events on Consulting, Banking, and other industries.

The Affordable Care Act, if honestly represented, is a redistribution-of-wealth program that significantly altered the private health insurance market with a primary goal of providing greater subsidized coverage for lower-income individuals.As with all wealth redistribution plans, there are clear winners and there are clear losers. Is the average American a clear winner or a clear loser? While valid arguments could be made either way, I think the balance of data suggests to me that middle-class Americans – average US household income is around $51,000 – are hurt through much higher out-of-pocket costs, much narrower choices and disruption, plan cancellations, extra tax forms, being forced to pay for unwanted services in some cases, and high downstream unfunded costs. And for those not on it (which is likely for the average American, given only 12 of 350 million citizens are), it explodes state Medicaid budgets and fiscal liabilities at the federal level, so they are hurt by it too. This negative view is bolstered by the fact that it has never been majority-popular by any significant margin, and more people disapprove than approve of it, several years in.One middle-class American explained it this way: “Unless I’m catastrophically ill, I’m now required to spend $12,000 for the privilege of spending another $10,000 per year out of pocket on medical care.” That sums it up for our family too – though $12,000 per year is cheaper than what we're paying.Most important, perhaps: the entire program is at high risk of actuarial failure in the next ten years if nothing is done.Secretary Clinton confidently asserts that the ACA is “clearly working.” It seems to me we first need to understand how she defines “working.”When I pay for a refrigerator, computer, or service, I decide whether it's working based not solely upon what these products happen to do when I get them –the unexpected new features and whatnot – I also compare what I got to the representations that were repeatedly and earnestly made by its salespeople. A noisy refrigerator with a broken freezer compartment isn’t “working” if I was repeatedly sold on it with promises of it being quiet and ice cream-ready.In essence, I ask myself, “Was the advertising honest?” We all do.To that end, these promises were repeatedly made about the ACA:“If you like your healthcare plan, you can keep your plan, period.”“If you like your doctor, you can keep your doctor, period.”“The typical family of 4 will save about $2500/year.”“We can do all this without adding one dime to the deficit.”“A site as easy to use as Amazon.”“We predict 21 million people insured by the ACA in 2016.”“23 government-sponsored healthcare co-ops will help deliver better access to care.”“This is not a tax.”These are not minor representations about how the ACA would work. They were, and are, important commitments that were repeatedly made. They were repeated so often because they resonated. They mattered to people. People who dared raise questions about any one of them were scoffed at, even mocked.The president even said before both houses of Congress, “If you misrepresent what's in this plan, we will call you out.”No doubt these repeated, forceful assurances caused some of us to go from opposition to support – though it remained highly divisive and still never earned significant-majority popular support.Some of us likely reasoned that surely, the biggest representations, many made after the details of the ACA were known, couldn't possibly be so blatantly lied about. After all, in many instances when these assurances were made, the ACA was either in final statute form or even already law.It's late 2015. Here's the tally:Broken. Called “Lie of the Year”, in fact.Broken.Broken.Broken.Nope.It's a year away, so we don't yet know, but enrollment predictions have just been halved to 10-11 million.12 of the 23 have already declared bankruptcy, taking with them billions of dollars in taxpayer-funded loan guarantees.Broken (see Supreme Court.)On each of these important representations, the ACA is most definitely not working.Yes, there are several laudable goals and even accomplishments of the ACA. And even if you subtract out the millions of people who involuntarily had their healthcare insurance cancelled on them (including my family of five), it does look like it has net-expanded the number of people that have gotten insurance, at a price.On the flip side, about 70% of new ACA enrollees are under Medicaid, which is 100% subsidized; they essentially pay nothing to support it. Many of the remaining 30% also get some form of subsidy. A 2015 McKinsey study indicates that insurers are currently taking $2.5 billion in annual losses through the program. UnitedHealth, the largest participant in the ACA marketplace has said their losses are about half a billion dollars and are unsustainable, indicating they will likely exit the market next year. Cigna, another large insurer, also confirmed that they are taking losses with the program. Two significant sources of revenue – the “Cadillac Tax” and the Medical Device Tax – are likely going to be repealed soon, primarily at Democrats' urging.So, given the above, can you help me understand the math that still makes this program work, while also adhering to promise #4 above? I realize it’s complex – Professor Gruber might even say it’s opaque, or remind me that I’m stupid – but even I just can’t grasp the basic math that keeps this program afloat in the long term to foot without continued massive increases in deductibles, out-of-pocket costs, narrowing of choices, or expansion of the federal debt.Yes, the ACA has removed the legality of plan cancellations based upon pre-existing conditions, a huge and largely positive change in isolation.Secretary Clinton, to be honest, I think your characterization that it’s “clearly” working at a minimum has to be balanced against whether it’s actually delivering on the repeated promises that were made about it when it was put forward. And doing so, it's far from clear that the ACA is “working” as promised or even as represented.As mentioned above, the ACA, if honestly represented, is a redistribution of wealth law that reshapes the health insurance market. There are winners and losers. Many of those of us in the latter camp do support the notion of improving America's healthcare, but we also wish we weren’t so blatantly and repeatedly lied to, inconvenienced, price-hiked and insulted. We’re footing the bill for much of this, and at a minimum deserve a little respect – which starts with honesty. And then maybe even if any ACA fans are so inclined, a bit of gratitude.Secretary Clinton, I appreciate you (or your staff) participating directly on Quora.If you're a reader and some of my thoughts above resonate with you, and you aren’t too busy figuring out where to spend your $2500 savings this year, I’d be honored if you added your voice by clicking the “Upvote” button.Related reading:Obamacare Is Now on Life SupportObamacare Enrollees Are Reeling from High DeductiblesLatest ObamaCare Flop: Enrollment Will Be Way Below PlanThe Biggest Threat To Obamacare Is Already Written Into Law: No Insurance Industry Bailoutshttp://www.newsweek.com/obamacare-will-ditch-two-million-jobs-over-ten-years-403033

He is absolutely correct about the ACA (Obamacare.) It is collapsing. As for Medicaid, it depends upon how one defines “working.”Evidence that the ACA is collapsing abounds.Aetna has exited the market. Aetna’s exit alone will force over 600,000 people to search for new plans.United Health has exited the marketCarepoint Blue Cross is exiting MarylandCigna has exited the marketIn 2018, at least one credible forecast is that one in three counties in the United States will have only one providerThis month (May 2017), the ACA became extinct in 94 of Iowa's 99 counties, as a small insurer, Medica, which had been the last man standing, followed Aetna and Wellmark Blue Cross Blue Shield out of the program.A 2015 McKinsey study summarized that insurance carriers are losing, collectively, $2.5 billion per year. That number has risen substantially over the last two years as Aetna, Cigna and Humana have all indicated they've lost money.More than one insurance CEO has stated that the ACA is in a “death spiral.”Think it's all because they're greedy corporations? Well, 22 out of 23 nonprofit healthcare coops are losing money too, and 12 out of 23 have gone bankrupt. Perhaps there's something systemic there.In many major markets, insurance premiums are rising more than 20%Most participating carriers claim that the healthcare pool is older and sicker than would be necessary for a well-functioning risk poolThe CBO had forecast that by 2017, more than 24 million people would be enrolled. 2016’s enrollment was flat, and there are less than 50% of the people forecast that are enrolled — roughly 11 million people are participating.Even from the consistently pro-ACA folks at Vox, we have:Declining choice, far fewer signups than forecast, carriers exiting the marketplace, executives declaring it in a death spiral, carriers collectively taking large losses and citing that the pools are far sicker and older than forecast… perhaps someone can explain why these, collectively, are not signs of collapse.Going back a few years, let’s review the most significant, most-oft-repeated promises of the ACA:“If you like your plan, you can keep your plan, period.”“This is not a tax.”“If you like your doctor, you can keep your doctor, period.”“A site as easy to use as Amazon.”“We can do all this without adding one dime to the deficit.”“The typical family of four will save over $2,500/year.”These statements were made frequently during the sales phase of the ACA and shortly thereafter. They were repeated often on the campaign trail because they resonated with voters. They mattered. They’ve not been delivered.As for Medicaid, that’s a pretty big topic, and one that is probably addressed on a separate Quora thread. On many measures, Medicaid is doing what it’s charged to do. On other measures, it will be a huge fiscal burden on states and the federal government unless very significant changes are made. Ryan’s statement that it’s “not working” is quite subjective, based on what “working” means.