Cigna Predetermination: Fill & Download for Free

Litigation/lawsuit financing & funding - Juridica, Lake Whillans, Burford, Harbour. Financing litigation based on potential outcomes and strength of case.Intellectual Property/IP, invention capital - Intellectual Ventures, Acacia, etc. Sometimes IP is a major hedge fund asset/recovery in bankruptcies (i.e. Nortel, Kodak), but latter is not that unusual.Insurance-linked securities (ILS)/event-linked securities - Nephila, Fermat, etc. Catastrophe bonds or cat bonds where issuer pays premiums (yield) to investors who will pay out principal/reinsurance cover upon defined trigger events:Parametric - i.e. wind speed for a hurricane-linked bond, ground acceleration for an earthquake-linked bondModeled Loss - sponsor's exposure exceeds a specified dollar amountIndustry-Loss Index - bond is triggered when the amount of the overall industry loss from an event exceeds a certain amountIndemnity - triggered when the sponsor's actual underwritten loss on specific insurance policies exceeds a predetermined amountHybrid - combo of above, often cover multiple eventsERP/IT systems strategic value vs. book value arbitrage - Leeward, etc. Valuing strategic value instead of ERP/IT's book value and lending/financing against it.Litigation-driven Chapter 11/distressed debt investing - Aurelius, Regiment, etc. Focuses on securities poorly structured by lawyers/issuers with loopholes that are not reflected in the current market price. Slip-ups by lawyers/issuers: preference actions, inter-creditor subordination rights, illegal cram-downs/cram-ups, unperfected liens, cross-default provisions, fraudulent conveyance, fraudulent transfer, breach of fiduciary duty, double-dip claims, etc.Insurance agency commissions based loans - Oak Street Funding, etc. Lending against future annuity-like cash streams of insurance policy premiums.Chapter 11/bankruptcy vendor/trade claims - Contrarian Capital, Avenue, etc. High barriers to entry. A vendor for a bankrupt company may want to sell its right to receive payment for its inventory previously sold to the bankrupt company, preferring liquidity now even if it's for pennies on the dollar. These trade claims are unsecured, non-recourse. Not typical distressed debt strategy in Ch. 11 (i.e. distressed unsecured, secured credit w/ in capital structure).Bank capital release/insurer capital release deals - Hedge funds/special opps funds/investors reinsure or cover a loss layer in exchange for a premium. Blackstone Tactical Opportunities' shipping loans deal with Citi freed up regulatory capital for Citi, CIGNA VA (variable annuities) loss portfolio transfer deal with Berkshire Hathaway freed up regulatory capital for for CIGNA.Some others, most of which can be securitized:- air rights, usually regarding rights to air space above certain grounds- water rights- Alex Song's mention of appraisal rights- tax liens- mechanics liens- any other liens- tax credits, tax assets and liabilities- revenue-based venture debt- royalty-based financing- personal net worth securitization- working capital financing, collateralized accounts receivables/payables- premium financing and lease financing- CoCos (contingent convertibles) or other hybrid contingency debt- life insurance settlement contracts- excess/deficiency reserve-based (re)insurer financing- lottery winning annuitizations*In summary, if there are:1. Potentially varying cash flow outcomes.2. A distribution of probabilities that can be assigned to each outcome to quantify upside and downside risks.Then it can be a trade-able/investable situation where a fair net present value can be ascertained.Oh, I forgot the most effective, abnormal strategy:Insider trading - SAC, etc. Perfect information but illegal and cowardly.

To understand how M4A would worsen the shortage of doctors you need to understand how Medicare as it exists now, covering only older Americans, is making it worse.Medicare predetermines how much a service or procedure will be reimbursed. There is no negotiation or discussion of rates. You accept the rate or you do not treat Medicare patients. As a result bureaucrats and non physicians are determining how much physicians are paid. What has been the result? Without any real pressure to offer a fair rate Medicare (and Medicaid) have become the worst paying insurances in the United States. Far worse than Blue Cross, Blue Shield, United Health Care, Aetna, Cigna and so on. Many physicians because of this low rate do not even see these patients in their offices. Others will limit them to a percentage of their practice. Medicare often does not pay enough to cover expenses.And worse, Medicare since it is arbitrarily imposed, does not pay all physicians equally. Certain specialties are reimbursed at rates far higher than others. So there is pressure going back to the choice of residency/specialization pushing physicians away from certain types of medicine. This is helping to create an imbalance of physician supply.I will give you an example from my own field. For an hour of anesthesia Medicare will pay $78. Blue Cross will pay $320. So in a real day you may get 5 or 6 hours of actual OR time. Time spent setting up a case, evaluating the patient, reviewing labs is not paid. Only actual OR time is paid. That is why over an 8 hour day we may only have 5 hours of OR time. Most of us did not do 4 years of college, 4 years or medical school, 3 to 7 years of specialized training, accumulate $200,000 of student debt and delay starting our careers until we are in our 30's to earn $400 per day with Medicare.Even in government run V.A. hospitals and county hospitals anesthesiologists are on a salary at a far higher rate of reimbursement. So even government realizes it can not hire qualified physicians at that rate.Imagine M4A where all those rates are predetermined. Physicians would avoid many specialties. Many students would not go into medicine at all. The shortage today will be nothing compared what will occur. Of course the US is importing thousands of foreign born, foreign trained physicians who will historically accept those lower rates because they are still better than what they would receive in their home countries. They are outsourcing your medical care.Currently physician reimbursement is only 6% of all Medicare costs. Cutting physician reimbursement to zero would have little effect on overall costs. There is no plan to rein in other costs. Hospital CEOs will still earn $800,000 per year. Nursing costs will not change. Anyone who thinks that reducing physician reimbursement is the solution for reducing the cost of medical care in the US is deluded or lying to you to get elected.Even in Canada the physicians negotiate rates with the government. It is not imposed.Medicare for All will only worsen the current physician shortage because it will only aggravate many of the current factors contributing to the problem.Physicians are bright. They have choices while still in college. As Medicare for All poisons the work environment for physicians word gets back. Fewer people will choose medicine as a career. Law, engineering, finance and many other avenues will offer brighter futures. We will see in medicine what happens in any industry the government attempts to control.Venezuela has the largest oil reserves in the world. After nationalization oil production has fallen steadily and become more expensive. We can see the result today. The government started with optimum conditions when they took over and 20 years later it is a disaster.There is no enterprise the government can not ruin when they take control.Why is SpaceX launching missions to the international space station instead of NASA? Why is NASA incapable of launching an American into space today?There is no business the government can not make worse by taking it over.Medicare for All is no different.

Why do companies offer co-pay programs? Is this some form of charity?No, it is not.It is cost sharing between the beneficiary and the insurance company similar to the deductable on your auto, renter, homeowner, commercial insurance.Why do they offer to give consumers a variety of premium pricing option? The lower the copay, coinsurance, deductible, and OOPM, the higher the premium costs.SOURCE: slideplayer[Annual] Out-of-pocket maximum [OOPM]is the most you could pay for covered medical expenses in a year. This amount includes money you spend on deductibles, copays, and coinsurance. Once you reach your annual out-of-pocket maximum, your health plan will pay your covered medical and prescription costs for the rest of the year.Copays, Deductibles and Coinsurance | CignaSOURCE: insurance - Take care of yourself!Premium: A monthly payment you make to have health insurance.Copay: is a predetermined rate you pay for health care services at the time of care.Deductible: is how much you pay annually before your health insurance starts to cover a larger portion of your bills and range from several hundred dollars to thousands of dollars.Coinsurance: is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan; usually 20% out of pocket and 80% by insurer.Explanation of Benefits (EOB) details the cost sharing between beneficiary and the insurer.SOURCE: Deconstructing EOBs -- Those Pesky Medical Forms That Baffle Us | Rockland County Business Journal