How do you welcome to create a life you love? Which is a series I do for WSCS and hopefully Rude Rangers TV, I think it's being aired on there, but I don't know.  And a lot of us don't know really what that means, who that is, so on and so forth. So what I want to say right now right here is we are going to talk about that. We're going to put it all on the table, well, as much as I can, and we're going to go from there. One of the things that I have been very blessed throughout my life as I get really comfortable is that growing up, I had a very, very unique for me upbringing. And I don't remember a lot of my childhood, but I also don't care that I don't remember a lot of my childhood because that's a past I'm focused on now, I'm focused on moving forward. And I'm really blessed that I can have that perspective. Very rarely do I hold on to something from the past, which is a key to creating the future. If you're steady holding on to the past and what happened to you yesterday, last year, or oh my God, two years ago, five years ago, 10 years ago, let it go because that is stopping you stopping you from all the blessings that are in front of you. You can't go into, I always compare it to energy, okay? You can't go into this beautiful existence that you want, which is an energy of lightness carrying all this heaviness, right? So let's just say it right here right now. Nobody had a perfect upbringing. I don't care what your life looks like right now or what anybody's life looks like right now. I don't care how much money people had growing up. Nobody had a perfect upbringing, okay? Everybody, no matter what their parents did, what their life looked like from the outside, everybody had their stuff, okay? We all have stuff growing up. We all have stuff in school. It just looks different. We all have stuff as adults, right? We have stuff that we have been given as gifts on our path to help us learn to cope and to create, okay? So we're in a generation now and please, if you like what I say, awesome. If you don't like what I say, nothing I can do about that. We have come into this generation that is debilitating, okay? It is simply debilitating because we're in a place where everyone thinks everybody else is responsible for. Hold on to your seats. They're feelings. You said something I didn't like. It was uncomfortable for me to hear that, okay? Use your problem-solving skills in your mind and fix that. Things are gonna happen you don't like. If you didn't learn in childhood to hear something you didn't like and cope with it, learn it as an adult because there's a lot going on out there that we don't like, everyone. You're not unique. On a daily basis, we hear things and see things we might not like.  So without those things that we don't like, without those things that we find uncomfortable, whether they be feelings or actual, feelings are actual things, don't get me wrong, but actual things like physical things in front of us, we don't have the opportunity to find a solution, a resolve, okay? So part of everything that happens in our life even in childhood, whether we remember it or not, is something that is helping us create our life and our future, our moving forward. So no matter what your past is, you have to look at it as a gift, as a present that allowed you to create where you are now. And if you don't like where you are now, guess what, it's okay, because you have the ability to create, recreate, co-create this existence that is amazing. I don't care who you are, what your background is, where you come from, what happened, why it happened, you have the ability to create an existence that is amazing. Now, without going into too much detail about my past, because again, it's my past. It might've helped me get to where I am and have a lot of understanding for where I am, but it no longer dictates where I'm going. And I sure enough, don't carry it around with me like a victim. If we are in that space of, but this happened, if we say, but and follow it up with anything like, this happened or this statement, you don't understand. Okay, you're probably right, I don't understand because I don't have those thought patterns, change your thought patterns. But I didn't have a perfect upbringing, I didn't. Believe it or not, I don't know anybody who has. I don't know anyone who comes from a perfectly functional, perfect parents situation. And again, I just said this on Psychic Medium, Tony Green. My show that airs every Monday at noon on YouTube Live on Rude Rangers TV. They air it on Roku or Roku and on Amazon Fire. And I think on Apple TV. But I just said this, if you had the perfect life, the perfect upbringing where nothing went wrong in your life, please write that book, make that into a movie because I think everybody would like to know, what's that like, what's that about? But I spent a deal of my childhood in foster care. And for the reasons that we go into foster care, not because, and my mom was not abusive to us. I did not go in because of physical abuse from my mother. Okay, it was more of a, this is a lot more than I wanted to put out there. It was actually being left with people who were babysitting for us that should not have been and inappropriate things happening at a very, very young age. Okay, so I wish I could stop this and redo it and take that part out, but all right now, here we go, we're just gonna continue. Okay, so having said that, I think I just wanna stop this show and delete it right now. I'm not comfortable talking about myself like this, but I'm just gonna stop now. But the point is we all have stuff and we all have the ability to create, to take those things and use them as tools to help us form our future or roadblocks that keep us stuck. And if you think for one moment, that just because you perceive somebody else's life as better than yours, that it was better than yours, they just maybe don't put their stuff out there.  It doesn't mean it didn't happen. It doesn't mean they didn't ever have a bad experience. Maybe they just don't let it rule their life. Now, I believe everybody has a purpose and the things that form us, even in our early childhood, help us become the people that we're meant to be. Even the things happening today in our life are helping us become the people we're meant to be tomorrow. You have gone through a very unique set of circumstances, an extremely unique set of circumstances, even if somebody else went through what you went through, even if somebody else experienced some of your experiences, nobody has experienced exactly what you have in the way you have. Nobody can bring your experiences to the table.  And I believe I don't care what anyone says. Every single person has a purpose, a reason for being here, something they are here to accomplish. And in many cases, we have many purposes. Sometimes it involves from here to here to here to here to here, and it's in the same industry. Other times you can go from being this, like I started in the health and fitness industry at the age, I think of 16. My first job was in a health club, and I loved it. I would have probably stayed in the health club industry my entire life. Like working out is one of my favorite things. I know most people just hate it, but I love it. And I love muscles. Like I have a really small bicep, but I love my little bicep. It's so hokey, but I love it. I love working out. I love the endorphins it releases. I love the feel of working out. And I've known since I was very young, strong body, strong mind, strong mind, strong body. They go hand in hand. It's that willpower, that control of yourself.   Trust me, this girl knows. Okay, so my first career was in the health club industry, and I was there until that particular club went out of business. And it was an all women's health club, and I love that. Okay, I did. And I worked my way up to a district manager where I was managing three clubs, and I was so happy. Now, my idea of a dream job and somebody else's idea of a dream job are completely different because we are unique. We're not all supposed to have or want the same things. I'm very blessed. Growing up, nobody ever told me, you're supposed to be this when you get older, you're supposed to be that when you get older. It just kind of happened for me, and it always happened naturally. Like, whenever one step was done, another step was there. When the health club closed, one of the girls who was an employee of mine called me and said, hey, where I'm working, they have an opening.  Get here now. I didn't even get interviewed. I walked in there like, start. Cause she had told them about me, and I was like, okay, what do I do? And so, I've always gone with the flow. I've never been in that place. Well, we all have moments, and I'll tell you about one of my moments in a moment. We all have moments where we fall, sometimes, literally. And we all have moments where we falter. Okay, where there's a little hiccup, but do we let that, you know, do we let it keep us down? Do we let it put that big rock or boulder on our back that we can't get out from under, right? No, no, we don't. Instead, instead, we keep moving forward. We don't get to the point where we fall, and we don't especially get to the point where the boulder's on our back. And then if the boulder is on our back, if we feel like there's a boulder on our back, we just have to say to ourself, the boulder's empty. It has no weight. I'm gonna get up and I'm gonna keep going, okay? I believe and I know with every ounce of my being, the more we're in the flow, the more we're moving forward, the more we're going on that path, on that track, in that direction, to where we wanna be and what we wanna do, even if we don't know what it is. Listen, when the health club closed, I had no idea what my next step was gonna be. I showed up for work, there was a sign on the door, closed bankrupt. We didn't know it was going through that. The employees didn't know. So I turned my little car around, went home, and as soon as it hit the news, my friend called me. I didn't even have time to be like, well, I'm gonna take a week off from working eight in the morning till nine at night, seven days a week. My friend called me and said, hey, I got the hookup. And I said, okay, and I went. Okay, and again, I was working. I was working like however many days a week, because that's just who I am. I don't care. Now what? Somebody else's idea of the perfect job, their purpose, might be that nine to five, that set structure thing. To me, that's like prison to me. I could never do the same thing over and over every single day in the same place, but that is being uniquely you. Okay, and there's nothing wrong with nine to five. For those who love the consistency, who can't handle change, nine to five is beautiful and perfect, but that's also why there are so many different careers available. Okay, now let's get back to you being uniquely you. Deep inside each and every one of us, there is something. For each of us, it's different. And it can be the same career. It can be, excuse my little itches. It can be the same career, but it's done differently, because only you have that way of doing it. You, even if you're doing the exact same job as the person next to you, only you can do it the way you do it. You bring your uniqueness to the table to do it in that way. A lot of people are doing careers or working jobs they don't love. And okay, we all have bills to pay. We all have maybe babies to support or animals to support. I don't, my babies passed away, my little doggies. Again, TMI. I need to stop letting my stuff fly out during this show. By the end of the show, people are gonna be like, I didn't know all that. Nobody knows all that about me. And I work really hard, not work really hard. I'm just kind of private. Like I don't talk about my stuff like that. Anyway, we all have things, what we have to pay. What we have to pay, what we're supporting, whether it be our mortgage or our rent or our car payment or our phone bill, it doesn't matter. So we might have to do that J-O-B until we get into our purpose, okay? And for each person, whatever your purpose is, and I'm gonna tell you something, your purpose is what you already love. It's what you are already passionate about, what you are already always looking up online, always thinking about, can't wait to get the next thing of it. Right? That's part of your purpose. Now, I've said this in many of my shows in the past.  She's up there watching down on me. Actually, she's right here. For those of you who don't know, I'm a psychic medium. So I do, I see dead people all the time. My mom is one of them. Anyway, my mom had her, when she was putting herself through school, bartended part-time, when she was working her nine to five, she also had a part-time always. She baked wedding cakes. She didn't go to school for that. She didn't get training for that. There was just something inside of her that my mom could always bake or cook. She would just amazingly be able to like get into this mode where she would just know what to put in a cake and start baking it. And the way she, she could decorate a wedding cake and you would not know she did this in her kitchen. You would think this came from a bakery that specialized in wedding cakes. That's how good, and the taste, oh my God. I miss my mama's cakes. I'll just tell you that for sure, I do. But she also baked, she was an amazing cook, she was. So even though she had her nine to five, she had a part-time thing that was her passion. And she could have taken it full-time if she ever would have wanted to. But she liked the security of her nine to five and the insurance. And even after my mom was retired, she still worked all the time. She worked at the ADS and she just always was doing something, okay? So whatever it is you're doing right now, if it's not, if it doesn't feed your passion, if it doesn't feed your fire, it's not your purpose. What your purpose will do is get you out of bed in the morning and get you running. Now, I'm not saying there's not fear with following your purpose because there's always steps to be taken. There's always something that's going to come in and you're going to have to change something in your life possibly to get there if you're not there. And yes, it does take action. So if you have gifts, oh, I have gifts. Great, start using them. If you have something inside of you, a desire, an invention, a book, an idea for a show, you have to start putting it out there.  I don't, my personal stuff, I don't even put it on the computer until I'm ready, ready to be. You wouldn't believe the stack of notebooks I have full of handwritten gibberish that no one else could read because it's my content. I don't want, like, if somebody takes my computer, I don't want them to get it, right? So if it's something that you don't want someone else to get or steal, then put it out there energetically. Work with your angels, your guides, whatever, whoever you work with. I know CEOs of companies that are, no one would ever guess this, but every morning they sit down. I know one guy particularly who sits down every morning with Vince Lombardi and he has a round table with these people who were, he truly admired, and I'm not gonna say he's calling them in, but he sits down and discusses his day with them and then perceives their answers back to him. And maybe they really are there because once we're on the other side, we're omnipresent, we can be everywhere at once, and we can help those who call on us to help them. So sit down with people who have done what you've done. If you wanna work with energy in a new way, call in Nikolai Tesla. If you wanna work with whatever it is you wanna work with, energetically work with those people and your angels, your guides, those who have passed on who have already accomplished what you wanna accomplish, call them in, have them help you, put it out there. Your way of doing it, even if it's already out there is needed. If you have an idea, if you have a thought, it's being given to you because it's something you're supposed to use, you're supposed to put it out there, you're supposed to bring it to people. Even if it's not a full on career, it's something you're supposed to bring to the masses, no matter how many those masses are. Every person I know that's an inventor says pretty much the same thing. Either they were meditating or they were deep in thought or they were thinking about it and the ideas just started flooding into them. Where your attention goes, your thoughts grow.  When you're talking about your purpose and many of us have many purposes, trust me, again, I started in the fitness industry and here I am now doing this. And when I started doing this, I was terrified. Not everybody in my family loves what I do. As a matter of fact, I am the only one other than my youngest brother, Stephen, who has Down syndrome and also is very gifted. Nobody else in my family even wants to talk about this with me. If I bring it up, they cannot change the subject fast enough. And one of my sisters even said to me, don't bring it up to me or my girls and we don't have a problem with it. And that's okay with me. You wanna know why I'm not supposed to share it with them. They're not my people to work with. Thank God. I can't even imagine if my family was constantly like, is mom here, is grandpa here, is my aunt here? I mean, that would be a full-time job in and of itself. So not everybody is supposed to love your purpose or your passion or even understand it. That's okay, who cares? Okay, who cares if they don't? It's not for them. This is your life. It's about you and you're the one who takes the ball, who takes the reins, who takes this by the horns or whatever thing you wanna say and rides it to your glory. So when I started this, doing this, first of all, again, I was a little terrified. Even though I'd done it my entire life, I didn't know it was, it was a thing because things just come out of my mouth, gets me in a lot of trouble. A lot of trouble sometimes. Things about myself, things about others. When people are talking to me, answers just come flowing out. I'm just gonna take a quick pause here and say for those of you watching me on WSES, if you'd like to see the rest of this show, please go to YouTube, Tony Green Psychic Media and you'll be able to watch the rest of this show. Thank you so much for joining me on WSES.


Gili, ydych chi'n cael wneud yn ymgylchedd? Mae'n cael i. Mae'n gweithio'n bwz yn gweithio'r gwahanol. Mae wedi'u fawr i chi'n gweithio'n gweithio i gael dychynig a'n fawr i chi. Mae'n gwneud hynny yn ymgylchedd hwnnw, ac rwy'n gweithio'n gweithio'n gweithio. Mae'n gweithio'n gweithio. Efallai ychydig yn fawr i chi'n gwneud hynny?  Yes absolutely, I think one of the last things I'd be affraid to say would be that we will not get over it, especially in the summer. I don't think, many of the lads have spoken since the game, I haven't got over it either. So it's still very fresh and you want to do that one better like I said, but there's going to be a lot of hard work. Felly we know how hard it's going to be to get to there next year, but I think to the lads that are still here from the M Games, it'll stand us in good stead. You think it's important for you as a player and obviously as fellow players, your team mates as well, to have the benefit of going through that last year and maybe use it to fuel you heading into next season and be on the disappointment that's still there and, like I say, using it to fuel what we want to go on and achieve this year? I think ultimately we wanted to get promoted last year and we didn't do that, so it kind of was a bit of a failure from our side. The experiences of some of the way games that we went through were big games we played in and we had to get results like the late Northern game, the last game of the season. Also the playoff games, the atmospheres we played in, we want to be involved in them again as a team. So I think it's standing us in good stead, but we know it's going to be, like I said, it's going to be a tough season again. Some good teams are coming to the league, some good teams have dropped down, some good teams have come up, but from us last year we were a good team. We played as well as anyone when I was doing, adding a few players here and there and making things click in different ways, I'm sure that will be a good team this year. You've been here a while now, the third spell at the club now, but this is your second contract since you've rejoined. How have you seen yourself and felt yourself grow as a player? We've seen probably a little bit more leadership from you over the past few years as opposed to when you were here the first time and things like that. Do you think your game and your personality has really developed over the course of your career and since you've likely returned here? Yes, I think it has. I think being around the Gaffer and Glen as well, they've brought us on a lot. Playing is in a different position obviously in centre mid. That's helped us out a lot of being more vocal like you said. It's not just on the pitch, off the pitch I can be a leader as well. I can help the lads coming into the club. There's a lot of expectation on the place and in and around the place, so you've got to deal with that just as much as being a good player. Whatever my role is, I want to be playing every game. That's obviously why I've come back. I want to be playing, I want to be pushing lads and the competition that we've got this year I'm sure will be good. It can only be good for the squad to push us on and to get us over the line. How important is that when you've got a lot of personalities in the dressing room? Like you say, a lot of different leaders, not just one captain or two or three players who are vocal and will take that mantle. But when you've got friends in the squad as well, you've obviously got a group with the North East boys. You all understand each other on a personal note and you're all able to take on that responsibility individually and collectively in terms of being leaders. I think we've got a lot from last year. The lads that are still here, there's a lot of good lads in the dressing room. A lot of good pros who do it right. I think if you can get a good group of lads together and everyone pulling in the same direction, that's half the battle. If you get everyone who wants each other to do well, they want to do well themselves, but also they're pushing each other on. Like I said, that competitive nature of we're going to be pushing each other for shirts, starting 11 on Saturday. That can only bring the best out of you. Like I said, bringing in new players and adding to the squad that we already had. I think we weren't too far away last year and I think it was just about making things right. Adding a few players here and there. You mentioned the Gaffer, obviously being here in a few years now. You've grown into a bit of a different role under him and played in different areas across the pitch as well. How good has that been for you in terms of bringing more out of your game and you're being challenged to do different things on the pitch, but it's making you a bit more of a rounded player as well? I think I've played in a few different positions with the Gaffers coming in, even wing back or centre mid a lot last year. He's brought it out of the side of us that a lot of other people who are managers wouldn't have seen. Playing in that centre mid role and I've enjoyed it, my first full season in there. I've still got a lot to learn and a lot to improve on. Like you said, there's more of a rounded player and bringing a few attributes out of me that I didn't really know I had. Still a long way to go to get that final product of how good I can be, but something I need to work on. Like I said about the competition, that'll surely bring it out of us. I guess again when you talk about the length of time that you've been here across three different spells, the relationship that you've had with the supporters seems to be a good bond there. That's kind of growing still isn't it a little bit? Heading into obviously a season where we want to be able to achieve success and have a successful season and give them something to cheer about. I guess on a personal note, they resonate with you and you can resonate with them now given the fact that you've been here as long as you've haven't seen as much of what you have really. Yeah, like you said over three spells I've seen a lot. I've played in some big games, I've had some bad times as well when it's not been going well, but they've always stuck by us and they've always been there and it is the biggest club in the league. They've always, like I said, stuck by us and I think for myself I've gone through some sticky patches with them. I haven't been playing as well some games but I think all I wanted you to do was to show that kind of passion to fight and want to play for the club and I do enjoy my time here. I've said that many a time. I enjoy my time here, me and my family. When joy is coming down here, my family always come and watch the games. It is a special place when it's going well like it was last year. It's very enjoyable so that's the kind of season that we need to be having again. How determined are you for that? I talk about falling short on a few occasions and being a part of teams since you've been here over the three spells that haven't quite got there and hit the heights to go one step further this time around and obviously over the next two years and achieve that success that we're all craving. That will be a really good one. I think that's the aim. Gaffer last year said the aim was to get promoted. Like I said, we've fallen short last year with the last hurdle. For a lot of lads, that might have been the first time in a kind of playoff position of getting them playoff. So it will stand us all in good stead and I think if we can just pass on their messages of what we need to do when each game being so important. I think that was the main thing for me last year from first to last game. Each game is so important. You need them points and the games come round quickly. Little messages like that to be put into the dressing room and then obviously it all adds up to the end of the season and everyone's got to be determining the dressing room to be getting that promotion. I think that's the main aim. Back in this week for pre-season, how much are you looking forward to that and of course being back out here again playing next season? Looking forward to seeing the lads. Obviously kept in touch with, like you said before, a few of the north-east lads over the summer but haven't heard from a few of the others. So looking forward to seeing all of them. Obviously it will be hard work. Always going to be hard. I think Greg will have us doing the brief test on Thursday. So that's to look forward to. But yeah, back out here as well. It will be good obviously pre-season games to get them done in justice and then get the real stuff started. But yeah, looking forward to it.


First of all, on behalf of the participants of the IAIS conference, it's a pleasure and honour to speak to you. Thank you very much. We've heard you talk a lot about inclusive finance over the years. Now we're talking about inclusive insurance. What is inclusive insurance? Well, it will be like inclusive finance, but more focused on the insurance side, and that is giving the possibility to every man and woman to be able to protect themselves against unforeseen risks, against external shocks, speed, health, drought, no rain, so that they can actually carry on with their lives. I was one time in a visit in Africa, and I was taken to a family, and because of the illnesses of their kids, they had to pay very high medical bills, and that meant that they had to basically sell a livestock by which they had milk, and that was their assets. They could sell and actually buy more food. So that meant for this family that they went from two meals a day to one meal a day. So my question would be that family would actually have some health insurance. You know, they could actually at least protect themselves about all those risks that they cannot deal with them now. It's also about stability of their life, their day-to-day life. It is about stability of their lives and actually sort of smoothening consumption, because that's basically what happens all the time. So when families work so hard, so hard to make ends meet, to build their assets, you know, as in two goats, three goats, four goats, or one cow, or two cows. Which is a huge change for these families. They work extremely hard, and then try to get the children to get an education and do everything right, but then something unexpected happens and then it all flies away. And I think it's very important that we think about these issues. Like, for example, the World Health Organization has stated that every year 100 million people fall back into poverty because of lack of health insurance, because something happens and they really have to sell everything they have to pay those bills. So having insurance can be a life change for people, you know, for the good or for the worse. Absolutely. And it would be also a way to protect their own family but also their assets in which they work so hard to actually get to and which means basically their income, the future income. These are mostly low-income or very low-income people. Insurance companies are for profit. So what's in it for them? I mean, can they make money out of these people? What's in it for them? Well, today we know financially excluded, there are 2.5 billion adults around the world. That's half the adult population. That's an incredible amount of people. That's an incredible amount of people. That's to even the most basic financial services. And I would say that insurance is a little bit more developed than having a transactional account or a payments account. So that would mean more than 2.5 billion adults that do not have insurance. So the market is huge. I would say in the short term, yes, you could say it's not the most enticing market, but in the long term it is because it will grow. And also with innovations and technology, we can actually reduce the cost by actually making these products even more profitable. And we've actually seen that even in payments. I mean, we're not relying anymore from brick-and-mortar type of banks. We're actually having mobile phones doing the payments for us. We've actually reduced the cost and actually given some room for profit making in the lower segment of populations. So eventually also for profit insurance companies there is an opportunity there among these 2.5 billion people. There is a huge opportunity there. Absolutely in the long term, there is a huge opportunity there. One day I was in Tanzania and I was talking to women and they were trying to get some health insurance. And so basically she got the health insurance and after a year she wasn't sick. So she didn't go to the doctor. So she didn't use, of course, any doctor's appointment. So she said, well, I want my money back. I want my premiums back because I didn't use my insurance, my doctors. So I said, well, that's not really how it works. So the issue for the insurer was, okay, how do I do to actually get her still be loyal to the insurance in the long term? Because that's the only way it works.  And then so these mentality issues, I think that's a whole education that needs to be extremely important. It's a very important issue because even if the need is enormous, sometimes the demand for the product is very low because of lack of education. You also gave once a very nice example from Rio de Janeiro, a visit there.  What was the problem? Well, I think I think that example sort of outlines how important it is to understand customers and their way of living. So the CEO of an insurance company in Rio de Janeiro was explaining to me, you know, there's most of the low income housing is done in favelas, which are basically on the side of the mountains or the morros, like they say it in Rio de Janeiro. And you have very big rains and because there's not, the construction has not been very well done, you have a lot of mudslides in which houses go down with the mudslides. So he wanted to come up with insurance product that would actually ensure people their homes. So the need was enormous, people were actually sort of stating this, but the problem is that the demand was not, they wouldn't buy it. And why? Because he realized that, you know, even though the grandfather probably held the property rights on that piece of land, many families had built different rooms on that piece. And on, and on, and on. And as you know, they're always building up. So he had to come up with an insurance product that would actually cater to this need, that actually the property was maybe on one person, but the premium would be shared by many families. And so he did that and the product just took off. Can you talk a little bit also, you're talking a lot about private families. What about small entrepreneurs? I mean, they need financing, right? And they need very often insurance. Can you talk a little bit about that? Is that the same problem as with private families? It is very much the same problem.  And they don't even have access to the most basic financial products, so let alone insurance. So that is definitely a vague issue. And what we've seen, actually, in most of these small and medium-sized enterprises, when they're insured, they actually get better access to credit. Why? Because they're seen as less riskier. So I think the need and the combination between insurance products and credit products is something that we should look even further. It's extremely important for the development of a country. I mean, they can employ people, they make money, they make a profit, so it's terrific. For employment, for development, reducing inequality, SMEs are extremely important and, you know, insurance could play a very, very important role. You've been involved in this issue for a number of years now. What has been achieved? Is it a successful journey? Well, I would say I would hope to say that it is. And I think it is. Actually, when I started talking about these issues in 2005, everybody was speaking about only micro-credit. And nowadays, people do understand not only credit that people need, you know, there's a host of financial products that people need, you know, insurance being a very important one. So that's one thing. And the other issue that, you know, people have become to realize, it is not only the micro, but also the small and medium-sized enterprises that also need a host of products to, you know, develop, to invest, so that they can actually employ more people. So I think the understanding is there. I think now 50 countries have learned the national strategies for financial inclusion, which I'm extremely proud of. 56 countries, yeah. I've actually stated there, you know, policies for financial education, which is a very important part. I think Peru is a good example, right? Peru is a great example for consumer protection and for financial education. And what I think is very exciting is that nowadays, countries are learning from each other. I think Peru, for example, is a very good example of how financial education can actually help demand and help the stability of the whole sector. You see actual results. We see actually, there's actually Tanzania. I visited Tanzania when they had 20% of the population included, financially included, and they stated a sort of national strategy for financial inclusion and they went from less than 20% to 57% in four years. Four years. Surpassing their own target of 50% in 2016. So it's very exciting. And I think that would also... We've had a fantastic innovation that nowadays I can send money to you with a mobile phone, which makes it really very accessible and very affordable for people to do and to have. Without the middle man and have, you know... Without the middle man, Without the brick and mortar bank of actually having to be there with, for example, this very little population in a rural area, nowadays you can do it with a mobile phone and that opens a huge amount of opportunities to actually give that person through their mobile phone different types of products. It empowers people. And that will empower people. And that will include it in the economic system and I think that's very exciting. Having all that new technology also opens a window of opportunities also for insurance. What can insurance supervisors do? I mean, a lot of these people are watching this videotape. What can they do in this field? Well, data. Facilitate data to actually examine risks better, to understand the market and the client's better is extremely important. I think trying to talk to the private sector and entice to sort of go down market is also very, very helpful. And third, be open to innovation. Because I think, you know, a lot of them are. And I think that the organizations that we now all gather together has been very open to innovation. And they've been themselves as a standard-setting body. They've actually been partnering with implementation partners to see, you know, how different innovations take practice in given countries. So I think that be open to innovations like mobile money is one innovation and a lot of central banks have been very open. And I think that in terms of designing new products for people like this Rio de Janeiro example, or even having new types of distribution like with mobile money, we have to be open for innovations because otherwise we're not going to make it to those 2.5 billion plus adults. What would be your central message for the people in this conference? I mean, if you have just one message you could convey? I think the standard-setting bodies have done an incredible amount of work on the financial inclusion area. And I've seen the growth of interest in this area. I mean, they have changed their core principles. They have actually written guidelines. And so that's very, very positive. I think it'd be fantastic if they continue to do so. I think it'd be great if they could, you know, partner with implementation people so that they can actually see how we can improve the guidelines even further to actually even make it, you know, on the practical perspective, you know, more helpful. And like I said, data, education, being innovative and trying to help people to learn from each other. So that has been achieved a long way to go? I think that we have a long way to go, but we've actually done a lot already and I think that we should continue on this path. Thank you very much. Appreciate it. Thank you.


So good morning everyone who's listening via YouTube. This is the house health care committee and we are doing our first video committee meeting. So bear with us. I think we have a general understanding of what we need to do to have this go well. We have all of our committee members here this morning and we are live on YouTube. So I think the first order business is simply to welcome our witnesses. We have scheduled, I'm looking, trying to look at my schedule in front of me. So let me start first by saying just very quickly that thank you to the committee members and to acknowledge that the work that we did before we left the state house on House Bill 742 proved to be very important in laying the foundation for moving ahead with emergency measures, some of which we're going to hear follow up about today and later next week. And of course we know that 742 became the vehicle for additional legislation as well of emergency basis. This morning, we're focusing on insurance issues in this time of dramatic changes. We want to make sure that we as a committee understand what has now been set in motion to try our best to ensure that for Monters, whose lives have changed dramatically and suddenly continue to have as much access to health insurance as they can. As much access to health insurance as possible. Our witnesses this morning include Sebastian, I don't think I've heard her last name pronounced before so I'll just say Sebastian for now and let you introduce yourself. Well, we have the Department of Financial Regulation, then we here have the, from Diva, we have Addie Stromelo, who's going to talk about the open enrollment on the exchange. And we've asked Susan Gurkowski and Sarah Teachout to be with us to update us on changes that MVP insurance and Blue Cross Blue Shield of Vermont have made. We'll try our best to stay to our schedule but appreciate your flexibility. So with that, Sebastian, I would welcome you to introduce yourself by name and what role you're playing. And I understand that you are prepared to walk us through an emergency rule that DFR has recently promulgated with regard to some aspects of insurance. So with that, I'll turn it over to Sebastian and I'll remind committee members that if you have questions, if you raise your hand on the screen and I'll try my best to track that but let's first listen to Sebastian. So good morning and welcome Sebastian. Thank you for joining us. Good morning. Thank you, Representative Lippert. My name is Sebastian Arduango and I am an Assistant General Counsel at the Department of Financial Regulation. As you know, the language in 742 regarding DFR's emergency rulemaking during the COVID-19 outbreak includes expanding patients access to and providers reimbursement for healthcare services delivered remotely through telemedicine, telehealth, audio only telephone, and brief telecommunication services. For the last week, we have been working with stakeholders including the Vermont Medical Society, by state primary care, Blue Cross Blue Shield of Vermont and VP Healthcare and others to develop an emergency rule on healthcare services delivered through these means. And I wanted to share with you what the work we've done on that so far. So the rule has been drafted and we sent a draft out to the stakeholders for feedback and I just wanna say thank you to all of the stakeholders for their very timely and thoughtful input. And in response to that input, we made some changes to the rule and that is what I'm going to share with you today. So the first- Sean, can I interrupt? Just say that I do not believe we have seen the rule in its draft form. So if it's possible to review the rule generally as well as changes that have been made by the stakeholder input, that would be helpful. I will send the draft and the red line with the changes we made in response to the stakeholder feedback to Demis so you can take a look at that. So what the rule does in very broad terms is that it allows health insurance plans to or requires health insurance plans to provide coverage for healthcare services delivered remotely through telehealth or audio only telephone as though they were provided in person. So this is sort of the telephone office visit situation and it also requires health insurance plans to provide the same reimbursement rate for these services using equivalent procedure codes as though the service was being provided in person. Because these services are supposed to be equivalent to in-person office visits, health insurance plans can charge the deductible co-pay or coinsurance that would be otherwise permissible if the service was being provided in person and health insurance plans have to cover the same number of telephone or telemedicine consultations as they would for in-person covered services for each covered person. In addition, the health insurance plan has to notify members in advance that, sorry, the health insurance plans may require practices to notify members in advance that services delivered remotely will be billed as an in-person visit, but the practices can permit providers to notify members during the same call and no other consent to receive remote services are required. Finally, with respect to the telephone and telehealth office visits, health insurance plans can't require providers to have an existing patient relationship with a member. So to the extent that plans have existing member requirements for telemedicine or telehealth, we're going to require them to waive those requirements during the duration of the COVID-19 outbreak. The rule also addresses coverage of telephone triage services and these are brief calls where say a member is calling their provider to ask whether they need to go in or receive any follow-up services. We are requiring health insurance plans to provide coverage and reimbursement for HCPCS code G2012, which is consistent with guidance issued by Vermont Medicaid. And this code covers virtual check-ins via telephone. And I think the biggest change between what we're doing and what Medicaid is doing is that we are requiring coverage of the G2012 code for both federally qualified providers and rural health centers as well as all other providers. So for commercial insurance, the idea is that all providers will use that code for telephone triage services. We are also requiring health insurance plans to waive any deductibles, copays, or coinsurance for telephone triage. With respect to coverage of store and forward, we are requiring health insurance plans to provide coverage and reimbursement for HCPCS code G2010, which is the remote evaluation of a recorded video or image. So the idea here is that if a member has a rash or something like that, they can take a picture of it and then send it to their provider. And then the provider can follow-up later with a diagnosis or instructions to come in or pursue any follow-up treatment. And with that service, we are also instructing insurers to waive any applicable copays for the duration of the COVID-19 outbreak. We're also exercising our authority under each 742 to move up the implementation date for the store and forward provisions in the bill to May 1st, 2020, if a declared state of emergency related to COVID-19 exists at that time. And the reason that we chose May 1st as a date was to give the insurers time to implement that. So I think that should strike balance between what the insurers need and what the provider community wants. We also addressed the issue of claims retroactivity in the emergency rule. And we are directing all health insurance plans to process and reimburse appropriate claims for telephone trios services and healthcare services delivered by a remote means, i.e. telehealth office visits retroactively to a date no later than March 13th, 2020. Which would be consistent with Vermont Medicaid. And to the extent that any state regulations require compliance with HIPAA as far as the devices used for telehealth or audio only telephone services, we are leading the consistent with guidance issued by the Department of Health and Human Services. So providers will be able to utilize any non-public facing remote communication product that is available to communicate with patients. So for instance, a provider could use Skype to provide telehealth services to a patient but they could not use Facebook Live. The rule also addresses mental health parity and for the mental health parity section, we have more or less parroted the language that is already in Vermont law in Title VIII, section 4089B, stating that health insurance plans cannot establish any rate term or condition that cases a greater burden on an insured for access or treatment, access for or treatment for a mental health condition delivered remotely through telehealth, audio only telephone, store and forward or brief communication services. So that language is the same as in our mental health parity statute. And finally, we've addressed the physical location of remote services, saying that health insurance plans cannot deny or limit coverage or reimbursement of healthcare services delivered remotely based solely on the physical location of the patient or the provider. Okay, does that cover the provisions generally? Yes, that was pretty much all of the major provisions in the emergency rule. Okay, you mentioned that it's a draft at this point. Can you talk about the likely effective time, effective date or what the plans are to have it become effective and whether you've received all the stakeholder input that you had requested? Yes, at this point, we anticipate 8742 to become a law on Monday after review by the governor's office. And our plan is to have the rule become effective as soon as 8740. We just lost you. We just lost your connection is frozen, Sebastian. Can you hear me? No, I can hear you again. Okay. You had said it froze just at the point you said the law becomes effective hopefully on Monday with the governor and then you intended and then it froze. Okay, our intent is to have this emergency rule become effective when 8742 becomes law. Okay, so this is all being done in anticipation knowing what the contents of H42 authorize you to do. Is that correct? That's right. Okay, good. Okay, anything else you wanna add before we open it up to questions, Sebastian? No, I just think all of the stakeholders again for their timely input on the rule and for helping to put it together so quickly. Okay, can you briefly, before we open up, can you briefly indicate who the stakeholders were that you asked for input from? Again, Sebastian, you appear to be frozen without sound. Should there, maybe you're back. I'm sorry about that. I have DSL internet at home and my wife is teaching a school on another Zoom call at the same time. Yeah, it's... Okay, so I was asking about the range of stakeholders and maybe if that doesn't make sense to list, let me ask this, did the healthcare advocate's office were they invited to have input? We did reach out to the healthcare advocate and we had significant input from the provider community and from the insurers. Okay, I think at this point, let's open it up for questions and I see that Representative Donahue, I'm gonna do unmute you, your hand up. If others have questions, please indicate by quote, raising your hand and I will try to recognize you. Representative Donahue, I don't think I'm hitting unmute. I don't know if it's actually... No, I think I had to unmute myself. Okay, okay. So I wouldn't have thought of this question if it weren't that we had an email or some of us had an email inquiry the other day. Am I correct that after the new bill has passed, if an out of state physician who can then ask for an emergency license for practicing in Vermont and at that point, those services would also then be covered. So it's my understanding as far as out of state physicians that the state has widened its request under the Emergency Management Assistance Compact. So that enables any physician or other provider that's licensed in any other jurisdiction in the country to practice in Vermont. And we also issued an emergency rule last week waiving provider credentialing requirements for insurance companies. So it is easier for insurers to bring out of network providers into the network during the COVID outbreak. So does that mean based on the emergency rule that could happen right now? It doesn't require action from the medical board. The medical board, it just requires, it just means the insurer would be able to immediately credential. That's right. It means that the insurer wouldn't have to go through the credentialing requirements that are normally required as far as licensing and that there are fewer barriers to reimbursement for those providers. Okay, great. We actually gave misinformation to the person who was inquiring because we thought they had to wait for the law to be signed and for that provider to get a temporary license. But that could happen right away. And I'll let that person know to contact their insurer. Okay, I see several other hands up. I'm going to go to Jen first in the event that you have something that you want to inquire about with regard to what we've been talking about. And I, my, there you go. Thanks. So Jen Carby, legislative council, I just wanted to clarify, I'm not familiar with the emergency medical assistance act that is referencing the language. It's the emergency, it's the emergency management assistance compact. Okay, but the language of H seven 42 would allow a, as soon as it's signed would allow a, any provider who is licensed anywhere in the country to be deemed licensed in Vermont to provide services through telehealth or on the staff of a license facility without getting, without needing to get a temporary license or anything from the board of medical practice or OPR. Standing from them had been, that was the way to allow people to begin practicing in Vermont or delivering services to Vermonters immediately using things like telehealth. And I would defer to the, to DFR and that carriers as far as how the provider gets credentialed or gets the service covered for the Vermonters. Okay, I'm going to go to representative Houghton. I believe you. I've only needed you on my end. I'm good. Thank you. So I have two clarifying questions, Sebastian. The first one is you. I thought you said waving of co-pays, but I'm actually lurking at the emergency rule online. And it says a health insurance plan or a worker's comp insurance plan may charge. A copay. So I just want to get clarification on what that is about. So there, there are two distinct types of telephone and telemedicine services. One is meant to be a stand in for physical. A telephone triage. So health insurers can charge co-pays for office visit equivalents, but cannot charge co-pays for telephone triage services. Okay. Great. Thank you. That helps. And then my second question is, I kind of want to boil this down to how it helps providers and how it helps patients. So correct me if I'm wrong for providers. This will mean they will be reimbursed from insurance companies for both telemedicine services. They will be reimbursed from insurance companies for both telephone triage, as you call it, as well as other types of telemedicine and soon to be stored forward requirements as of May 1st. And for patients, it's going to help because they should have greater access to the healthcare providers while staying at home. Are those two statements accurate? That's right. Great. Thank you. Okay. I see that. So can you clarify again what the. Impact is on deductibles and out of box out of pocket maximums? The, uh, the rule does not address, um, deductibles and out of pocket maximums, um, except to the extent that it says that normal cost sharing applies to, um, public services. Um, office visits provided via telehealth or audio only telephone. We are, um, we have a call scheduled on Monday with the provider community, the healthcare advocate and the insurers to discuss. Waving, uh, um, Duration of the pandemic, but we did not address that particular issue in this emergency role. Okay. And, but am I. Was I, am I correct and understanding that with regard to specifics of COVID-19 testing and treatment, they have been waived. Apart from your rules. Yes. We issued a bulletin at the beginning. In the beginning of March. That waves, uh, cost sharing for COVID-19 testing, including, um, Any visits that are associated with that testing. Right. Okay. So just. If I can clarify at least again, that the rule that you're the, the draft rule, the emergency rule that you've been discussing with us. Is broadly applicable to telehealth services. Not just restricted to COVID-19. Treatment and triage, et cetera. That's correct. Yeah. Okay. I think it's important when we discuss these that. We understand what is broadly applicable. To all health health services and what is restricted. What changes may be restricted within quote, COVID-19 treatment, uh, testing and treatment, et cetera. Thank you. Uh, I see Brian. She has represented. She has a question. I'm going to unmute you. I think you should be free to talk, Brian. Okay. Thank you. So I think, chair, I think you just asked a lot of the questions I was going to ask, um, which is, which is good. So I won't repeat them. I just, just for clarification, I am going to ask, um, if I heard this correctly, that currently telephone. Uh, triaging telephone calls and are free from cost sharing. That telemedicine equivalence to visits or not, but it's, but you said that the department of financial regulation and insurers and the healthcare advocate are meeting to talk about the idea of waving, um, cost sharing for the duration of the pandemic. I don't know if I said exactly what you said. I, what, what's unclear to me is, uh, are you saying that you are looking at the option of waving all cost sharing or just, or all cost sharing associated with COVID-19. So eight seven forty two has three prongs as far as the data and the emergency rules and the emergency rule I was discussing just addresses the third prong, um, which is, um, expanding access to telemedicine and audio only telephone. The waving of cost sharing I was referring to in my earlier testimony had to do with the first prong, which is, um, waving or limiting cost sharing requirements directly related to COVID-19 diagnosis, treatment and prevention. And then we'll have another call, uh, with the stakeholders that is to be scheduled regarding the modification or suspension of health insurance plan deductible requirements for prescription drugs. And that's the second prong of the department's emergency rule making under eight seven forty two. Okay. Um, is there any discussion of, of, of waving the cost sharing for treatment for the mental health, um, needs of people related to the pandemic? There's been no discussion of that, uh, as of yet, but I expect that it will come up when we discuss the first prong of our emergency rule making authority with the, uh, stakeholders. Are you set, Brian? Yes. Thank you. Okay. I'm going to move on to, I see that, uh, represent Rogers has a question. Uh, I'm. I'm muting. You should be. Yep. I think. Um, yeah. Thank you, Sebastian. I was just wondering, I know, um, from the providers I've spoken with, there's, there, some of them are just struggling with the lack of consistency, um, insured one insurer to another. And I know that DFR can, cannot regulate, um, insurance plans that, that are covered under arrest. But I was just wondering from your perspective, if there are efforts being done to kind of mirror some of this work with maybe SIGNA or other insurers that, that, that, that DFR cannot regulate or also to mirror between the on exchange and off exchange plans, um, with Blue Cross Blue Shield and MVP. So the regulation, um, would apply to all fully insured plans. So that would be plans that are on the exchange as well as. Large group plans. Unfortunately, we, uh, we don't have any authority, as you said, over self insured plans under ERISA. But I suspect that that's something that will be addressed by the federal government in the next round of, uh, COVID related legislation to come out of Congress, just like how they addressed, um, COVID testing in the legislation that, uh, just went through the Senate this week. Okay. That's, that's helpful information to have. Thank you. I'm on. Okay. We're, uh, I'm just going to note that we're approaching not imminently, but within eight minutes or so of our time when we have scheduled, uh, the department of diva, uh, to talk about open enrollment. And my understanding is that they have a fixed time that's available of 30 minutes. Am I, do I have this right? Maybe I don't. But why, why don't we go on Emory, you have a question. And while you're asking your question, I will double check to make sure I have my time frames correct. So go ahead, Emory. Hello. You should be unmuted Emory. Hello. Now can you hear me? Yes. Yes. Just to be clear, this is not just for COVID related. Diagnosis or treatment and triage. This is for if somebody has a heart problem and can't go into the doctor because of COVID. All these other pre-existing conditions are covered under this. It's just not COVID stuff. That's right. This is a generally applicable rule. Um, it will apply to all healthcare services that are clinically appropriate to cover, uh, to provide the telehealth or audio only telephone. Okay. Thank you. Okay. Uh, any. Not seeing any other hands raised any further questions for Sebastian from DFR. Well, I'm going to thank you, Sebastian. And, um, will we be able to stay in touch with you throughout this period of time as we are going to want to hear about develop further developments at DFR? You would be the contact and appropriate person that we can ask to become a witness again at a later point in time. Okay. Thank you. Yes. And I will send Demis a copy of the draft rule as well as the, um, red line that we made in response to stakeholder input. Okay. Hearing no other questions. I'm sorry, Bill. I'm sorry. I have one last question. I'm sorry. Um, Sebastian, would it be possible to have you notify Demis who can notify us the day that you are putting this final, um, finalized bulletin out? Sure. I can copy Demis on our mailing to the secretary of state's office. Thank you. Yeah, that'd be good. Thank you. Thank you, Lori. Okay. Um, I think with that, we're a few minutes before our next witness, but as I said, they have a very fixed period of time and I think we have a lot that we want to hear from them. So I think at this point, uh, hearing nothing further, I'm going to say, thank you, Sebastian. And you can, uh, stay on and listen on if you, as you wish, but I'm sure you have other things you might want to do. Um, so committee, I'm going to just during the few minutes before, I mean, we're scheduled to hear from Addy Stramelow, who I do not see on our line yet. Unless, oh, yes, there. Yes. I see Addy. You're on by, are you on by phone, Addy? I am. Hello. Okay. Um, are you. So since you're on the line and I understood that you had a fixed period of time, is that correct? Perhaps we could start already and start a few minutes early.


the dedication and the spirit of our nation's silly service. The grating of ordinary service. America is passing into a new era, reversing a long, practical challenge that requires issues in your executive services. They've performed some excelled in savings or engineering projects. They've been kept up in a system of tried logistics that will be of considerable savings. This is an extraordinary list. Hi, Jeff Coat, for focusing on new construction of civil service. For sale, Army Missile Command, Research Center, National Hieronymity Space Administration, Office of Space Systems, Department of Health, Junior, Associate, General Deputy Assistant Secretary for Housing, Department of Housing, and Urban Development. Jeff Coat, Deputy Commander, David Jean, Madison, Chief Fiscal Analysis Branch, Office of Management and Budget, Avenue Service, Department of Treasury, David E. Manali, Associate, General Counsel for Air, Noise and Radiation, Environmental Protection Agency, Chronicle Systems Division, Department of Agency, Department Administrator from Overseas Schools, Department of Education, Joseph A. Sherrick, Deputy Assistant Secretary for Program and Budget, Department of Defense. While our staffmen couldn't be here receiving the honor, it's time as we belong Health and Human Services Department. Next is William C. Watson, Junior, Deputy Director Center for Disease Control, Department of Health and Human Services, Arvin J. Wilcox, General Counsel, Department of Navy, Walter St. William, Addicts and Space Administration, Thomas Young, Director, Godwood Space Flight Center, National Air and Addicts and Space Administration.