Mike Fieseler, CPL

Our Semi-Annual U.S. Insurance Labor Market Study has been the industry's go-to staffing predictor for 15+ years. Share your insights by February 1 and we'll send you the results. Help us track what's ahead for insurance talent in 2026. #InsuranceIndustry #LaborMarket #InsLaborStudy

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“Anthem” is not a cost containment strategy. 😑 I reviewed every group health plan (50–500 employees) across Indiana… and ... just....wow. 3️⃣ out of 4️⃣ companies are still offering their employees coverage from the the same two severely overpriced, claims-denying dinosaur carriers. 🦖 It’s 2026. If your broker is still bringing you the same two logos every renewal season, they’re not managing your costs… they’re managing their commissions. 💸 💡 Pro tip: In many markets, you can literally FIRE YOUR BROKER and contract directly with these two carriers to cut plan costs IMMEDIATELY. But if you want REAL, PREDICTABLE, and SUSTAINABLE cost containment, you need a modern broker who actually understands the 2026 landscape - not one still using the same spreadsheet from 2006. Indiana employers: stop rewarding legacy carriers for bad behavior. There’s a better way -- and it’s not the one your grandfather’s broker is quoting. 😉 #modernmafia #employeebenefits #indianapolis #humanresources

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Ceded reinsurance transformation is the move from manual, fragmented processes (spreadsheets, emails) to automated, integrated systems that improve efficiency, accuracy, and compliance. Driven by increasing risk complexity, regulatory pressure, and cost control, this shift focuses on automating contracts, claims, and reporting to reduce recovery leakage, speed up financial reporting, and strengthen financial control. It also moves ceded reinsurance from a back-office function to a strategic capability. If you’re exploring opportunities ceded reinsurance modernisation, upcoming transformations, or platform-led change in this space, I’m always happy to share insight and discuss how organisations are approaching it. Get in touch or drop me a connection request Cheers Scott #CededReinsurance #ReinsuranceTransformation #InsuranceTransformation #InsurTech

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Providers helping drive competition and ultimately savings to patients with a network strategy delivering value through employer health plans! #challengingthestatusquo

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Ohio’s ACA market is in real flux, and the numbers only tell part of the story. Over 100,000 independent workers are at risk of losing coverage this year, that’s people, families, and small businesses navigating an increasingly complex system. After almost 35 years in insurance, I’ve learned that proactive solutions make the difference. Agents who leverage tools and plans designed for today’s challenges can actually protect their clients, and provide peace of mind when coverage gaps feel overwhelming. It’s not only about policies; it’s about being in your clients’ corner when it counts most.

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Illinois Benefits Compliance Update: Dependent Parent & Stepparent Coverage Mandate (HB 5258) Effective January 1, 2026, FULLY INSURED group and individual health plans (including Cost+ plans) must offer dependent coverage for a parent or stepparent who qualifies under updated IRS criteria. For groups that renew after 1/1/26, it goes into effect upon their renewal. This does NOT apply to Self-Funded Plans, specialized health care service plans, Medicare supplement insurance, hospital-only policies, accident-only policies, or specified disease insurance policies that reimburse for hospital, medical, or surgical expenses. Who is eligible for coverage? • Parent or stepparent must live within the health plan’s service area (for example, for an HMO member, their parent cannot live out of IL), AND • Needs to meet the IRS “qualifying relative” definition https://lnkd.in/eMKXaKg2 (26 U.S.C. 152(d)). To summarize what a qualifying relative is…There are four tests that must be met for a person to be a qualifying relative: 1) NOT a Qualifying Child Test: The person cannot be your "qualifying child" or the "qualifying child" of any other taxpayer. 2) Member of Household or Relationship Test: • Live with you all year as a member of your household, or  • Be related to you in one of the ways listed under “Relatives who don’t have to live with you” • Relatives who don’t have to live with you include: your children (includes stepchild, foster child or descendant of any of them), siblings (including half and step), your parents (INCLUDE STEPPARENTS), etc. 3) Gross Income Test (for the year must be less than $5,050 for 2025 and $5,200 for 2026 (indexed for inflation)).​ 4) Support Test: The primary insured (employee/subscriber) must provide more than 50% of the parent’s total financial support for that calendar year. However, if two or more persons provide support, but no one person provides more than half of a person's total support. One more item to note:  • The parent(s)/stepparent(s) of the subscriber can be added if they meet the criteria for qualifying relative and live in the service area of the plan. • Parent(s)/stepparent(s) of the subscriber’s spouse are NOT eligible for coverage. Again, this IL state insurance mandate is generally preempted by #ERISA and only applies to fully insured groups with IL as their situs state. Carriers have updated their coverage to allow subscribers to add dependent parent(s)/stepparent(s) to their plan. For example, BCBS of Illinois added “Sponsored Dependent Parent” under the dependent type. IL House Bill: https://lnkd.in/ehGruTZE Be sure to update OE materials, SPDs, and eligibility verification processes (IRS forms/proof of residency) and coordinate with carriers to understand requirements. Questions? Consult your broker or reach out to me. #EmployeeBenefits #OpenEnrollment #HR

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Rx REBATE VALUE? Rebates have become a popular topic when it comes to health plan costs, and both Stacy Richter and Ann Lewandowski have done a great job of bring attention to the issues with and impact of rebates. But this episode of RHV is especially insightful because it brings up the issue of pharmacogenomics, or genetic testing to see how a particular individual will react to a specific medication. Think of it as a way to see if a drug is likely work for a patient based on their genetic make up, or if it might cause adverse effects, or if might not work at all. Sounds like a good idea, potentially eliminate patients/members taking drugs that won't work for them or could have adverse side effects for them. That should decrease wasted spending on prescriptions that won't benefit patients/members, and increase the effectiveness of care by targeting the right drugs from the beginning of treatment. Who wouldn't want to do that? Oh, but wait, the PBM agreement doesn't allow that. If pharmacogenomics are used the rebates are eliminated. Yes, you read that correctly, Pharma and the PBMs have negotiated terms that often prevent employers from using pharmacogenomics. Why? Because genetic testing could impact the dispensing of certain rebate eligible drugs, thus reducing Pharma's sales and the PBM's rebates. Yes, another example of "Profits before People" in healthcare. And another example of the importance of understanding PBM contracts and whether rebates are really worth it. IMHO - rebates are like over-paying for something with the promise of getting a portion of your overpayment back, and it's sold as, "What a great deal!" (Simple example - pay $5,000, get $1,000 back in rebates, but there's another drug available that's equally or more effective for $500 but pays no rebate so is not a "preferred" drug by the PBM.)

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