#healthcare

https://memorialhermann.org/about-us/bcbstx-negotiations

In the latest endless hit to our benefits, all Memorial Hermann providers will not be in-network starting April 1st, unless thisis resolved.

???

What are some good jobs for nurses? I work at a busy hospital and am really stressed out and a friend told me to check out insurance jobs.

In February 2026, Express Scripts was hit with a racketeering class action lawsuit alleging it used a Swiss company to disguise billions of dollars in kickbacks. The lawsuit claims this scheme diverted rebates meant for clients, violating federal racketeering laws (RICO) and inflating dr-g costs.

https://www.ftc.gov/news-events/news/press-releases/2026/02/ftc-secures-landmark-settlement-express-scripts-lower-dr-g-costs-american-patients

https://open.substack.com/pub/healthcareuncovered/p/express-scripts-just-got-sued-for?r=4gx0u9&utm_medium=ios

I see many folks hanging around waiting for a severance package. I get that I mean a kicker to go would be ideal especially if you are retirement eligible and this is your last stop in your career. If you have another opportunity outside the phone factory that meets or exceeds current salary/bonus pay and you are not retirement eligible, yet. What do employees gain by achieving retirement eligibility? What would be at risk if you left payroll 3 years before becoming eligible for retirement?

Potential known risks:
3 years of Pension contributions (assuming eligible)
30% service discount
ability to participate in AT&T healthcare plans at your cost 100%

Are there any other meaningful "benefits" at risk by leaving before eligible?

How many more quarter-zip pullovers with Iron Pulse logos will it take to buy your job? UP is doing this to keep you distracted from the fact they are trying to eliminate your positions. They even tell you in the Town Hall meetings they are using technology to consolidate as many dispatching desks as possible. Meanwhile, Vena has promised the NS ATDA dispatchers their jobs through a protection agreement. What has he promised you as a "valued member of the management team"? Nothing, absolutely nothing. In 2020 they cut people who only had a few years left to fulfill their 360 months for the full Railroad Retirement annuity. They will do it again! You are not special. This is not about being against the company; it's about protecting the career you dedicate and give so much of yourself to. You are trading small prizes for a possible guaranteed job, guaranteed wage increases, much better health care during your working years, health care after you retire, and protection against territory/dispatcher consolidations.

Here are few things to take in consideration. Bookmark this thread, you will need it. I hope others will chime in and cover things that I am missing but would be useful for ret. planning. Also, I might be off on a couple of things here, please correct me. Here we go:
1) “90 points” is a key milestone

• It typically equals age + years of service
• Hitting 90 generally qualifies you for full retirement status
• You also typically need at least ~10 years of service to receive retiree benefits at all
• Below that (for example 75 to 89), benefits may be reduced or prorated
• Even small differences matter - dropping from 90 to 89 points can increase your share of healthcare costs

2) Stock and bonus implications matter

• At 90 points, equity awards (RSUs, performance shares, SARs, etc.) often fully vest
• You may also retain eligibility for bonuses issued after leaving payroll
• Below that threshold, vesting may be partial or forfeited based on time worked
• These equity outcomes can be a major part of total retirement value

3) Healthcare is still expensive even with company support

• Pre-65: expect roughly several hundred dollars per month even with Chevron subsidies
• Example shared: around $800/month for individual coverage after leaving employment
• Post-65: total costs (Medicare + supplement + dental/vision) can reach ~$1,000/month for a couple
• Chevron’s contribution is relatively small (around ~$100/month range)
• Coverage quality is often considered strong, but you are paying significantly more than as an employee

4) Retiree benefits are weaker than employee benefits

• You may keep access to similar plans, but the company pays a smaller share
• Costs shift from “paycheck deduction” to direct out-of-pocket payments, which feels materially different
• Contributions are sometimes prorated based on your “points” level
• There is also risk that company contributions could drop further over time

5) Medicare is not “free”

• You must pay Medicare Part B premiums
• High earners pay extra through IRMAA surcharges
• IRMAA (Income-Related Monthly Adjustment Amount) is an additional charge on Medicare premiums based on your income, which can significantly increase monthly costs for higher earners
• You will likely also need a supplemental (gap) plan and possibly dental/vision

6) Long-term risk: benefits can shrink

• Retiree medical contributions from Chevron have remained small and relatively flat over time
• Some retirees reported large premium increases (for example ~80% over several years)
• Benefits depend on company performance and policy - they are not guaranteed to improve
• Planning should assume rising costs and limited company support

7) Financial planning is critical

• Retirement income (Social Security, dividends, etc.) can push you into higher cost brackets for healthcare
• You cannot rely on “appearing low income” to reduce costs if you have substantial assets or income streams
• Many retirees bridge the gap to Medicare using savings or tax strategies
• Healthcare becomes one of the largest and least predictable expenses in retirement

Get your Doctor appointments - full evaluation, Refill medicines, Surgeries if any.
Complete your ARAG / Will or Trust settings if possible
Get a free financial analysis

Looks like it got popped and fell to the ground with an empty basket. Let the ones who fought for your good wages and100% paid healthcare( The Union ) keep your basket full and quit counting on those who care nothing for you. All deals must go thru The Union first.

Over 3,600 individuals lost jobs in Illinois during the first 90 days of 2026. The Illinois Work Center site reported 3,695 layoffs in this period. Manufacturing facilities experienced the highest number of job losses. The healthcare industry also saw significant job reductions. These figures only include businesses required to issue WARN notices.

https://101theeagle.com/illinois-layoffs-2026/

Blount Memorial Hospital announced layoffs affecting 85 workers. These changes will take effect on May 1. The hospital is contracting out its food, nutrition, and environmental services. Most affected employees will be rehired by Compass Healthcare organizations. This move aligns operations with the broader Prisma Health system.

https://www.wbir.com/article/news/local/maryville-blount/blount-memorial-hospital-layoff-85-workers/51-42928553-a4bb-4513-a5ed-9b1673228ae9

Supervisors were laid off today from the wellmed branch within Carenet health. Anyone from wellmed out there know when Carenets contract will end with wellmed ? Assuming that is sooner than later with the amount of clinic closures.

I’m young in my career and all three MCO’s I have worked at have been hellish, with Anthem being the worst by far. Wondering if folks have actually encountered a decent healthcare company to work at? Considering changing industries altogether because of how bad these places are.

(As an aside, Gail and team couldn’t identify true talent if it hit them in the face.)

The "Break Up Big Medicine Act," introduced in February 2026 by Senators Elizabeth Warren and Josh Hawley, seeks to dismantle vertically integrated healthcare conglomerates. It aims to prohibit companies from owning both healthcare providers and insurers, pharmacy benefit managers (PBMs), or wholesalers, reducing conflicts of interest, lowering costs, and increasing competition.

Fool calls my post fake but I don’t care if they get pensio or healthcare I deserve what’s mine been hear since 1999 that make me last millennial though I’m Gen X Gen Z can kiss my dump truck fake posts !!! I don’t vote but should

Rumor has it TPG is talking about stepping in to buy the struggling clinic after Optum couldn’t turn it around. We shall see…

So RJ has known that United Healthcare was in negotiation with Corewell hospitals (Michigan). Corewell wants 30% increase in payments over the next 3 years.

RJ didn't bother to tell Southfield participants this till NOW. Not even during open enrollment!!!

All Corewell Hospitals are/will no longer be in network. Maybe negotiations will come to an agreement, maybe not.

RJ HR dropped the ball because Southfield so much smaller?
Errrrr

Post only if anyone got an email or knows anything about RIF for El Paso

Any Optum FL CLINICS to be impactedtomorrow?

Lay off emails went out an hour ago. WM clinics in NTX region. PSRs and Ma’s. Could providers be tomorrow before the rally town Hall?

Anyone have any updates for 3/19 RIF r/t Optum Health or Appeals?

Kabuki Theater. Were they not at the table with the national during negotiations? If not, why not? The political environment is currently 100% against the union at the moment, including the NLRB. A new contract negotiation opens the union up to losing existing things that were not on the table with the extension. I don't believe Verizon will raise the healthcare caps and it's not Verizon that's raising the medical costs 10% a year, it's the healthcare industry. Union members should be more careful of who they vote for. When the 40 million dollar a year host of a Fox News show tells you that Bernie Sanders is a co-mie for trying to give you universal healthcare, maybe you should ask yourself if that host really has your best interests at heart? But on the upside I hear the Orange man is coming out with a better plan any day now /s

The pre 2008 hires are all terrible.

They voted to get rid of pensions for new hires.

They voted to get rid of healthcare for new hires.

They voted against job security for new hires.

They voted against us, now they want you to vote for them.

No thank you!!

Let’s face it we all know that one the unions didn’t do much of anything to get what was gonna end up being the offer in the end.Last year they were all about fighting to win things like caps on retirement medical ,but in the end the unions knew the environment they are in political wise along with on the company level work wise technology wise .Lets also face the fact they are concerned about the younger members who never been thru a strike along with making them go on strike for benefits they don’t have .So let’s all stop patting backs and just admit it’s was needs based decision .Call it like it is tired of Ibew and cwa pounding their chest about how great it is along with the problem isn’t Verizon it’s the country health care system.Lets be real the company said no way never gonna happen with retirees healthcare or pensions for younger guys take it or leave it .So the unions took it .Im okay with that but please wish the unions specially the CWA locals would just stop pounding their chests they rolled over a decade or more ago .Thats how we got to this point.So any of us thinking of retirement in next few years might as well forget that now .Also I’m okay with that but to the the unions just stop with posts please it’s making me sick every email and Facebook post

https://www.beckershospitalreview.com/legal/judge-orders-unitedhealth-to-hand-over-broad-discovery-in-ai-coverage-denial-case/

Illinois WARN reports indicate over 6,000 layoffs. The layoffs are scheduled for early 2026. The WARN Act mandates employer notification. Multiple sectors face job cuts, including health care and retail. TreeHouse Private Brands will lay off 168 workers in South Beloit.

https://www.mystateline.com/news/local-news/more-than-6000-illinois-workers-face-layoffs-in-early-2026-new-warn-filings-show/

A new report released by the bipartisan Senate Joint Economic Committee (JEC) on Tuesday found that overpaying for Medicare Advantage (MA) plans caused Medicare Part B premiums to rise across the board.

According to the JEC’s report, overpayments to MA plans caused standard monthly Medicare Part B premiums to go from $185 in 2025 to $203 in 2026.

The report defined “overpayments” as the difference between what the federal government government paid for MA plans versus Traditional Medicare (TM) plans. When payments to MA plans exceeds those for TM plans, premiums go up for both groups.

In 2025, MA plans were paid $84 billion more than it would have cost to cover the same amount of beneficiaries with TM plans, an average of 120 percent more.

Medicare Part B covers medically necessary services like doctors visits, supplies and some outpatient prescriptions as well as preventive services. Roughly 63 million people are enrolled in Medicare Part B and a little more than half are on Medicare Advantage, which combines both Part A and Part B.
The JEC further noted that the burden of MA overpayments are spread unevenly across the country as some districts and states have lower rates of MA enrollment. The report gave the example of Wyoming, where only 21 percent of Medicare beneficiaries are enrolled in MA, estimating that payers in the state will pay $25.4 million in excess premiums, with most of that from TM enrollees.

“Let’s be honest about the math, when Medicare Advantage is overpaid, that money doesn’t just disappear, it shows up in the Medicare Part B premiums seniors pay every month, including those paid by traditional Medicare beneficiaries who are not getting extra benefits,” said JEC Chair David Schweikert (R-Ariz.) said in a statement.

“If Congress is serious about affordability, fiscal responsibility, and fairness, we must take a hard look at Medicare Advantage and make sure the rules are the same for everyone,” he continued.

“Today, between aggressive upcoding, questionable quality bonuses, and structural overpayments in Medicare Advantage, seniors who stay in traditional Medicare are effectively subsidizing the system. That’s not sustainable, it’s not fair, and it can be reformed.”

Does anyone know if any teams outside of the clinics are getting hit again? I’m work in corporate but all I keep hearing about are the clinics closing or merging.

(This was a reply I posted in another thread, but it should probably be its own topic.)

Ever wonder why Cigna, UHG, Aetna, etc. are trying to branch out into different areas?
They’re hedging their bets.

AI efficiency is smallest piece in our layoff equation, but it is giving leadership hope that cuts will help bring profits.

Cigna, as well as every other publicly traded company, is outsourcing (offshoring) tech, admin, call centers, etc. in huge numbers. The remaining US employees are expected to absorb their newly-acquired extra job functions with the use of AI (Copilot in our case). AI is expected to increase productivity of remaining US employees by at least 2X.

As per usual, teams in India will make lots of noise and eat up company resources while providing very little new product and creating extra work for US-based workers.

Ultimately, Shareholders will still be pi---d because Cigna stock prices will continue to slide. The real reason for this slide isn’t is that employee costs are growing. Rather, it’s because health insurance premiums can no longer feasibly grow at the same rate as healthcare cost and utilization.

What we’re witnessing firsthand is an industry in turmoil. The once limitless dollars of the US commercial healthcare membership are drying up at an unbelievable rate. The Boomer demographic is coming home to roost and is destroying the market. GenX and Millennial employee dollars can’t stand the strain of Boomer retirees and job diehards.

You may ask “if Boomers retiring, how does this negatively impact commercial plans?”
The answer is that the US commercial healthcare member/client pays the lion’s share of the US (and the world) healthcare bill.
Providers have prices capped by CMS (Medicare/Medicaid) and many uninsured individuals just don’t pay. So that leaves the good ol’ American employee based plans to pick up the slack. But this golden egg-laying goose has hit menopause. It wasn’t expected so soon or so dramatically.

Employers are tapped out, so premiums can’t increase appreciably.
Individuals are forced to buy super high deductible plans while avoiding wellness visits and out of pocket costs.
Health insurer shareholders will continue to demand cuts until profits are acceptable.
This last thing is impossible.

This industry is no longer viable.
If you’re under 45 years old, be planning your transition. If you’re 55+, pray you can hang on and save.

For those of you who think single payer provided by Big Daddy Government is the answer. Well, just look around at the challenges those socialist utopias are facing and remember that SOMEONE IS PAYING THE BILL and someone else is trying to work a profit. It’s the same p-o in a different bag.

UnitedHealth Group’s slogan is: “Helping people live healthier lives.”

I lost my job at Optum in 2025 and remain unemployed. As a result, I also lost my health insurance. I cannot afford COBRA, and I have a serious health condition that is currently going untreated. Each month I am forced to choose between paying rent or paying for heathcare coverage.

Without treatment, my condition will eventually become terminal.

THANK YOU OPTUM FOR NOT CARING!

Know when to fold em
Know when to walk away
Know when to run.

https://www.reuters.com/legal/litigation/us-doj-says-aetna-pay-1177-million-resolve-false-claims-act-allegations-2026-03-11/

I have a concern regarding the tentative agreement in the Northeast.
I realize we paid a heavy price in 1989 and, as a result of that sacrifice, were able to keep essentially cost-free medical benefits for the next two-and-a-half decades.
However, uncertain economic times in 2016 resulted in us, fairly or not, shouldering more of the burden, not only the men and women that had 20, 25, 30, 35... years on the job under their belt already, but also the retirees now had to unexpectedly pony up and adjust to this new and unexpected financial burden on a fixed income based on earlier reasonable expectations and assumptions, if I understand correctly.
I am now hearing murmurings about about retiree healthcare skyrocketing, from, say, $60 a month to 10X that amount, $600 a month, for example. I hope these rumors are wrong and that I am needlessly worrying about something that will never come to be.
Are there any guarantees built into this new tentative agreement that shield both our current retirees, as well as those that will eventually be joining their ranks, from the future uncertainty of exorbitant increases that will make affordability a larger hurdle, if not an impossibility, for the elderly who served their union and their company well?

2008 the healthcare went away for new hires

2012 the pension went away

2016 techs started to become anti union and cross the line

2019 extended this cr-p

2022 techs become completely anti union. They threaten to cross the line if there’s a strike and give up on the rest of the union.

2026 why should I care if there no union in the union.

Federal layoffs impacted nearly 25,000 jobs in Maryland during 2025. The Maryland Women's Business Center launched a new program in response. Called 'Founders Rising', this 8-week program aids laid-off federal workers. It teaches participants to develop business concepts and launch new firms. Dr. Stefany Holguin successfully launched her healthcare consulting firm after completing the program.

https://www.wusa9.com/article/news/local/maryland/federal-layoffs-maryland-spark-new-entrepreneurship-program-support-displaced-workers/65-dbca2c8a-d8d0-4669-9ad0-5fe1e9c93d17

Last year company/union talks broke off supposedly over the raise in caps for retiree healthcare. Now we have a tentative contract where the info just released does not seem to address this issue at all. Did the company use that memory erasing device from the Men In Black movie ("neuralyzer") on the union? I guess we all just have to work until Medicare eligible, and then pray that they don't take that and SS away from us to give more tax breaks to Elon Musk and the other multi billionaires. Is anybody out there actually representing the working stiff?

Boulder City Hospital will lay off approximately 70 employees. It is also ending several services, including patient stays over 24 hours. The facility is transitioning to a rural emergency hospital designation by May 1. This restructuring is driven by financial conditions and funding changes. The new designation provides financial incentives, including a significant annual subsidy.

https://www.fox5vegas.com/2026/03/03/boulder-city-hospital-layoffs-service-cuts-coming-facility-shifts-rural-emergency-designation/

Can someone explain the significance of 90 points? Do they matter only for the company contribution towards healthcare premiums or do the 90 points come into play for other benefits?

A New Hampshire bill proposes freezing executive pay at Coos County hospitals. This freeze would occur if hospitals lay off 10 or more workers in a department. State Senator David Rochefort introduced the bill, citing accountability for Medicaid funds. North County Healthcare, which operates the hospitals, opposes the legislation. They argue the bill removes local control and could negatively impact healthcare.

https://www.conwaydailysun.com/berlin_sun/news/local/coos-county-hospital-execs-would-see-pay-frozen-in-some-layoffs-if-bill-passes/article_1a6004a3-f73f-41f0-ab25-e2c3c0d5e483.html

Anyone have any insight to the fate of those that started at landmark, then HBMC and now Optum at Home (OAH)? SO much has been cut, not much left..has the feeling that everyone will be RIFd by EOY..any intel??

Who do you think will take over the Optum clinics and who will take over the Wellmed clinics