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FMCA PPO plan


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I recent,y received an email from RV Insurance Benefits (Kerville TX, the broker used to work with Kyle I believe) about a new  nationwide PPO plan “designed by RVers” .  It appears to be sponsored by FMCA. — perhaps only for their members (which I am not)

does anyone one know about this?

 

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On 6/16/2018 at 6:12 AM, mkc said:

but there is very little info on the site.

That's a huge understatement. 

The site says policy holders have access to providers nationwide "or use the indemnity benefit."--with no other indication of what this plan they're offering actually is, never mind details like deductibles available, premiums, why there's a choice between the PPO and the indemnity (are they both included in the premium?), etc. 

The testimonials page is a head-scratcher.  They are mainly pleas by the letter writers to have something done about the health insurance situation and explanations of what they would like.  It doesn't appear that any of them have the plan that is currently being promoted (e.g., one person has a series of short-term policies, and someone else says, "It is our hope that if FMCA creates a plan that will cover this group of RVers it will cover folks in all types of RVs, not just motor coaches."). 

As far as I can tell, there's nothing whatsoever about the plan that they are now advertising--not in the testimonials, and not in the rest of the website. 

And it's not clear what the FMCA connection is.  The site has a banner that says, "A PPO Health Insurance Plan Offered by FMCA for RVers," but I couldn't find any reference to it on the FMCA website, and it appears you don't have to be an FMCA member to get it.  And at one point, they say, "Our team of licensed insurance agents are FMCA members," and they have the "FMCA Commercial Member" logo sprinkled about. 

I ran into similar issues with the plan that Escapees offers.  It's impossible to tell exactly what it is, which makes me suspicious. 

All of which is very disappointing because I'm a fulltime RVer who needs a health insurance plan with nationwide coverage--the very customer they're marketing to.  But they simply aren't forthcoming with what they're actually offering, and only by digging have I been able to figure out that they're not offering ta PPO plan with nationwide coverage, or even a close substitute. 

I truly hope people don't just fall for the marketing materials and instead make sure they truly understand what it is they're buying.  It would be nice if that was explained in the marketing materials, but I guess that's asking too much.

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Look at Christian Healthcare Ministries. If you do sign up, pm me so I can give you my wife’s number. She will receive a free month. We have always been reimbursed more than what we spent on covered health care. 

Ron C.

2013 Dynamax Trilogy 3850 D3

2000 Kenworth T2000 Optimus Prime

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On 6/30/2018 at 12:11 AM, Blues said:

That's a huge understatement. 

The site says policy holders have access to providers nationwide "or use the indemnity benefit."--with no other indication of what this plan they're offering actually is, never mind details like deductibles available, premiums, why there's a choice between the PPO and the indemnity (are they both included in the premium?), etc. 

~snip~

I truly hope people don't just fall for the marketing materials and instead make sure they truly understand what it is they're buying.  It would be nice if that was explained in the marketing materials, but I guess that's asking too much.

Looking back on the "nationwide PPO network" that was (is?) advertised by RVHealthInsurance, that one was a weird union-based program (you had to join the union) out of NY whose officers had been in trouble previously for forming the union solely so family members could gain access to health insurance. In that program, "access to providers nationwide" just meant they used the list of providers in a Cigna PPO, but the actual administration/claims processing was done by union management, not Cigna - a big red flag.

The disclaimer of "this is not major medical insurance" should give anyone pause.  Note that the religious ministries health sharing plans are also not major medical insurance.  They work for some, but one needs to understand the limitations/policies.

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On 6/30/2018 at 12:11 AM, Blues said:

I ran into similar issues with the plan that Escapees offers.  It's impossible to tell exactly what it is, which makes me suspicious. 

 

Forgot to add - the Escapees Healthcare solutions is just an indemnity plan plus minimum essential coverage through an OTR truckers' group for preventative care.  It is also not major medical insurance and will not be close to adequate for serious health issues.

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Most of what has been said here is correct. I am not well-versed on the plan referenced in the OP's first post (the PPO that may/may not be sponsored by FMCA) but I will definitely confirm that, at this point, what we offer through Escapees Healthcare Solutions are NOT major medical plans. We have not claimed that they are in any way, shape, or form because, aside from being dishonest, we do not want to mislead people into thinking they have  more coverage than they actually do. There is no worse feeling than being in a position of needing something you think you have provided for, only to realize you really don't have the safety net you thought you did.

MEC stands for Minimum Essential Coverage. This phrase refers to a class of healthcare coverage that includes preventative care, basic wellness services, and a few other things, but NOT major medical coverage. Every plan I've seen out there (even outside of our own offerings) that includes "MEC" in the name is a minimum essential coverage plan. What that refers to is that MEC plans are enough coverage that you do not need to worry about the tax penalty that comes with not having health insurance. MEC plans meet the minimum essential coverage rules set out in the Affordable Care Act, so their members/patients are exempted from the penalty.

 

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On 6/30/2018 at 12:11 AM, Blues said:

I ran into similar issues with the plan that Escapees offers.  It's impossible to tell exactly what it is, which makes me suspicious. 

All of which is very disappointing because I'm a fulltime RVer who needs a health insurance plan with nationwide coverage--the very customer they're marketing to.  But they simply aren't forthcoming with what they're actually offering, and only by digging have I been able to figure out that they're not offering ta PPO plan with nationwide coverage, or even a close substitute. 

I truly hope people don't just fall for the marketing materials and instead make sure they truly understand what it is they're buying.  It would be nice if that was explained in the marketing materials, but I guess that's asking too much.

As marketing director, and someone who cares deeply about our members, I agree with you. I want people to understand what they are signing up for when they subscribe to our WellMEC or other healthcare plans. 

I pulled this directly from our website: "WellMEC is an affordable, innovative healthcare plan that provides preventive care, vaccinations, and wellness services. Additionally, WellMEC is compliant with the minimum essential coverage requirements of the Affordable Care Act."

I ask this sincerely, because I want to ensure that we are being as clear as possible in our communication of this plan (without putting a big red flashing banner that says "not major medical" across the top of the page ;) )- what does the quoted sentence above mean to you, or leave you questioning? If you're suspicious that we're hiding something, then that means I haven't done my job well enough.

Communications Director

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On 7/2/2018 at 9:06 AM, Georgianne said:

As marketing director, and someone who cares deeply about our members, I agree with you. I want people to understand what they are signing up for when they subscribe to our WellMEC or other healthcare plans. 

I pulled this directly from our website: "WellMEC is an affordable, innovative healthcare plan that provides preventive care, vaccinations, and wellness services. Additionally, WellMEC is compliant with the minimum essential coverage requirements of the Affordable Care Act."

I ask this sincerely, because I want to ensure that we are being as clear as possible in our communication of this plan (without putting a big red flashing banner that says "not major medical" across the top of the page ;) )- what does the quoted sentence above mean to you, or leave you questioning? If you're suspicious that we're hiding something, then that means I haven't done my job well enough.

Why not put a big red flashing banner that says "not major medical" across the top of the page?  You know that's the crisis pre-Medicare fulltimers are facing--lack of options for health insurance, and if you're not offering a solution for that, then why not divulge that up front?

In fact, on that page, there is no mention whatsoever that you're not offering major medical insurance, so people seeking major medical insurance can't find that out until they start clicking around.

Also, by advertising that the plan satisfies the ACA mandate and is compliant with the minimum essential coverage requirements of the ACA, you're leading, or at least allowing, people who aren't immersed in this to infer that it is "ACA-compliant," which it is not.  ACA-compliant plans offer "essential health benefits," including emergency services and hospitalization.  You know, the things people typically associate with healthcare coverage, and what Escapees is offering does NOT include that, and again, a person has to click around to find that out. 

In fact, a common refrain from pre-Medicare fulltimers is that they would be happy to pay for preventive care themselves, if they could get coverage for illness and emergencies and hospitalization, and what Escapees is offering is exactly the opposite.

Yes, you don't state outright that the plan is ACA-compliant, and you don't claim that it's major medical insurance, but since that's what people affected by this crisis are looking for, it would serve them better to tell them right up front that your "healthcare solution" is not a solution for them.  Of course, that's kind of the opposite of "marketing," so I can see the conflict. 

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On 7/3/2018 at 12:21 PM, Blues said:

Why not put a big red flashing banner that says "not major medical" across the top of the page?  You know that's the crisis pre-Medicare fulltimers are facing--lack of options for health insurance, and if you're not offering a solution for that, then why not divulge that up front?

I wish this forum had a "cred/like" feature for posts.  This one describes in detail the issue.

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20 hours ago, mkc said:

I wish this forum had a "cred/like" feature for posts.  This one describes in detail the issue.

Hey, I try. 

I'll also point out that Escapees has an imprimatur when it comes to serving the fulltimer community.  So I think it would be even more important for the marketing materials for "Escapees Healthcare Solutions" to divulge that it's not actually what fulltimers are asking for, instead of calling it "a refreshing alternative to traditional medical insurance."

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On 7/3/2018 at 10:21 AM, Blues said:

Why not put a big red flashing banner that says "not major medical" across the top of the page?  You know that's the crisis pre-Medicare fulltimers are facing--lack of options for health insurance, and if you're not offering a solution for that, then why not divulge that up front?

Thank you.

Sometimes I think even Escapees doesn't "get" full-timer healthcare needs. For example, a year or so ago I had to explain the 2016 Health & Human Services SEP FAQ to Greg of RVer Insurance fame. He should have known about it before I did.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
DISH TV for RVs

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You've made some really great points!

I've reached out to Shawn, our CEO, and asked him to weigh in on some of the history behind why we don't currently offer a major medical option. In a nutshell, it's because we haven't yet been able to create an association that an insurance company will recognize as valid for their purposes. It has to do with insurance companies protecting themselves from individuals signing up for something just to get major medical coverage, which can cost them much more than they receive in premiums. However, Shawn has had more in-depth conversations that allow him to divulge details more accurately. Additionally, we're reaching out to Theda, our liaison with Friesen-Strain and ITG, to clarify the difference between ACA compliant and plans that satisfy the ACA mandate, as well as some other questions. Unfortunately, she is out of the office until Monday.

To address the warning banner of "not major medical," my apologies- I didn't intend to make light of the frustration you're feeling about not being able to find coverage, and I can definitely see how my remark could have been taken as disrespect. The reason we haven't taken that substantial of a measure is that these options DO work for quite a few. Not the majority, at this point, because of our struggles with obtaining a major medical option, but there are many who have signed up for WellMEC and Healthcare Assist, as well as the other options, because those plans actually do meet their needs. We want people to take the time and read through the options for themselves, in case there is something there that works for them. I have since added a note to the introductory paragraph that does state these are not major medical insurance plans, and will work with our team to see if we can edit some of the documents available on this page to make that clearer, too.

Please trust that we are actively working on establishing a major medical option for our members. We know the need is there, and we wouldn't live up to our values if we didn't try to meet it. This has been an ongoing conversation for quite awhile as we work with different contacts to research all available options and methods for securing major medical coverage for those who cannot obtain coverage through their employers or Medicare.

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Hi All,

 

Thank you for your thoughtful questions and comments. As Georgianne explained, we care very deeply about the plight members of our community face when they are unable to get access to medical care, at affordable rates. It was that very situation we were attempting to alleviate with Escapees Healthcare Solutions. However, we face a particular challenge in the marketing of the products offered through Escapees Healthcare Solutions. Those products, as are all insurance products, are heavily regulated and require special licensing to sell. As such, upon the advice of the insurance agents who helped us design and continue to help us administer the program, we had to be very selective about the language we used to describe the products. We could have done more to explore what these products are and what they are not. However, "marketing" can easily become "selling"--the crux of our challenge. Therefore, we erred on the side of caution, working closely with the aforementioned insurance professionals, to give enough information about the nature of the products, without crossing professional lines. Our intention was not to mislead members--an essential value of Escapees Board of Directors is that we are honest in everything we do--rather, we hoped to provide enough information to our members about the various products in Escapees Healthcare Solutions to inspire them to have a conversation with the insurance professional who are licensed to explore the suitability of those products, privately and on a case-by-case basis. I hope that helps. Please know, we will alert the insurance professionals to this conversation so that they can comment further. And, again, thank you all for your commentary. Your passion makes this community special.

 

Best  wishes,

Shawn R. Loring

CEO, Escapees RV Club

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Hello again!
I received an email this morning from Theda. I'm copying it below because she doesn't currently have an account on RVNetwork.

 

Hi everyone,

I’m Theda @ Friesen-Strain Insurance and servicing agent for Escapees Healthcare Solutions products. 

Some of you may already be aware the primary requirement for writing a group health plan is  there must be an employer/employee relationship and documents to support this relationship are required with group enrollment.   You may find Association health plans that are available to doctors, lawyers, ministers etc.. available through their  respective Associations/Unions.   Associations are difficult to write as I have tried for several years to find one that would consider Escapees.  The issue faced with various carriers is one of membership being too broad.  We are hopeful the Department of Labor’s final ruling issued on June 19th will expand options available regarding Associations. 

In searching for plans for Escapee members, Independent Truckers Group agreed to allow Escapee members the option of coming under the umbrella of the plans they offer truckers.  No, it isn’t a major medical plan, but, it does offer some benefits to those that refuse to pay outrageous premiums or for those that just don’t want traditional insurance.  Until we can find a major medical plan, this does offer a viable option. 

As of now, the penalty for not having insurance is still the law.   For those that have felt the sting of this penalty at tax time, you understand the need for viable options.   Also, if a plan was written prior to the law’s signing, it is considered “grandfathered” and exempt from some of the requirements.

ACA  - Individual mandate – the requirement for everyone to have insurance or face tax penalty when filing yearly taxes. 

ACA compliant – refers to specific set of benefits - EHB’s(ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse disorder services, prescription drugs, rehabilitative services, lab services, preventive and wellness services, pediatric services including oral and vision care) that must be included in plans to be considered ACA compliant.  Please note:  some “grandfathered” plans are exempt from some of the requirements.

The WellMEC plan will give you preventive care, immunizations and satisfies the Individual mandate so you will not be penalized for not having an ACA plan. 

 Also available is My Healthpass Plus – this plan gives you access to unlimited teledoc services  wherever you are traveling, and if a prescription is needed, will call in medications at a discounted price.  There are other benefits to this program such as some in home labs, interactive health assessments, savings on diabetic supplies, monthly supply of multivitamins etc.. 

Another option available in most states is  Axis HealthCare Assist – a limited medical plan, you can choose the level of benefit you want, the max being $10,000.  This is not a cumulative amount, plan will pay up to $10,000 for each service - hospital, critical illness, out-patient care, accidental death & dismemberment and it also has teledoc services built into this plan.  For those states this plan is not available, we have other options.

There are also dental and vision plans that are available for members.   All are guaranteed issue – no health questions asked.  Please keep in mind that does not mean there are no waiting periods for certain services.

Please feel free to call or e-mail any questions or if I can be of assistance in any way.

Thank you.

Theda


She can be reached via the information on https://www.escapees.com/benefits/escapees-healthcare-solutions/

Communications Director

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3 hours ago, Georgianne said:

No, it isn’t a major medical plan, but, it does offer some benefits to those that refuse to pay outrageous premiums or for those that just don’t want traditional insurance.  Until we can find a major medical plan, this does offer a viable option. 

 

Those of us who need real insurance would politely disagree that this is not a "viable option" and should not be represented as such.

At best it offers "well, it's better than nothing, but barely".  To suggest otherwise would indicate a lack of understanding of the needs of those who have to purchase medical insurance as an individual.

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On 7/5/2018 at 11:48 AM, shawnloring said:

. . . upon the advice of the insurance agents who helped us design and continue to help us administer the program, we had to be very selective about the language we used to describe the products. We could have done more to explore what these products are and what they are not. However, "marketing" can easily become "selling"--the crux of our challenge. Therefore, we erred on the side of caution, working closely with the aforementioned insurance professionals, to give enough information about the nature of the products, without crossing professional lines.

Really?

Let's look more closely at the sage advice you're giving on your current RVer Health Insurance Guide for 2018 . . .

escapee-insurance-options-with-text.jpg

 

FL has the only nationwide network? I'm pretty sure that's false. I did a cursory check of several state ACA plans using Healthsherpa and found BCBS PPO plans with nationwide coverage in Alaska, Alabama, Arkansas, and California (the start of the alphabet). Of course these plans aren't in the Escapee states SD, TX, and FL.

ACA Enrollment Time (not just Nov - Dec) can be any time if you change location and physically reside there long enough. See this Health & Human Services Dept FAQ.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
DISH TV for RVs

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17 minutes ago, Zulu said:

Really?

Let's look more closely at the sage advice you're giving on your current RVer Health Insurance Guide for 2018 . . .

 

That guide was produced by RVer Insurance Exchange. Our logo appears as "In partnership with" at the top of the website due to a longstanding business agreement,  but we did not write this guide. It was created a distributed by the owners of RVer Insurance Exchange.

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Zulu, 

The guide referenced above was written by me and me alone. Escapees did not write it, review it, nor approve it. Nor does it have anything do with with the products Shawn was referencing through the trucker's group offered through Escapees.

The chart you highlighted is one of several on our site created to help RVers in their own research. We have NEVER stated anywhere on our site that it is the end-all encyclopedia of healthcare options in all 50 states. Instead, we focus on those states where the majority of fulltime RVers reside. Florida is one of those states. 

Just because a plan is BCBS PPO does not mean it offers nationwide coverage. You would have to contact each and every company to ask about their policies. A near impossible task that would require someone with  a lot of free time to tackle (perhaps you know someone?) and by the time it was completed would need to be redone. 

This guide was written primarily for the 2018 Open Enrollment season (thus the OE dates posted) but I do make changes to it as needed. I do point out clearly at the top of the page in the first chart which you did not share about the Special Election Periods (SEP). 

Again, it is a guide. Use it to guide your research and choose the best plan available for you. Most RVers that have used it have found it very useful for that purpose. 

All of us  have all been doing our best over the years to keep up with the changes and to present healthcare plan options to the RV community. Obviously some plans work better than others and none should be chosen without factoring in your own needs, budget, and risk aversion. 

p.s. I seriously doubt Greg needed to be educated about SEP. He passed his ACA Cert test (4 times to date) which deals very heavily with SEP. 

 

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Kyle Henson, Fulltime RVer since 2011

Founder/Former Owner of  RVer Insurance Exchange

 

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1 hour ago, KHenson said:

The guide referenced above was written by me and me alone. Escapees did not write it, review it, nor approve it. Nor does it have anything do with with the products Shawn was referencing through the trucker's group offered through Escapees.

I guess I misinterpreted that large logo at the top of the page:

escapees-logo-cropped.jpg

Since Escapees didn't "write it, review it, nor approve it" what exactly does this "partnership" entail? There are plenty of folks on the RV forums who take the Escapees word as gospel. And that logo sure looks like a stamp of approval to me.

 

1 hour ago, KHenson said:

The chart you highlighted is one of several on our site created to help RVers in their own research. We have NEVER stated anywhere on our site that it is the end-all encyclopedia of healthcare options in all 50 states.

Your chart states that Florida is the only state with nationwide coverage. Wouldn't you need to have knowledge of all the health plans in all 50 states to make such a claim?

 

1 hour ago, KHenson said:

. . . we focus on those states where the majority of fulltime RVers reside. Florida is one of those states. 

That would be TX, SD, and FL, right? BTW, how do you know most full timers domicile in those states?

 

1 hour ago, KHenson said:

Just because a plan is BCBS PPO does not mean it offers nationwide coverage.

Yes, I know. For example, TN's "Network S" PPO plans spring to mind which seems to be just an in-state PPO like SD Avera PPOs.

On the other hand, from my very cursory, non-encyclopedic search of current nationwide health plans, it looks like BCBS of AL offers PPO plans with nationwide networks. Is there any way you could check? It's just one state.

 

1 hour ago, KHenson said:

You would have to contact each and every company to ask about their policies. A near impossible task that would require someone with  a lot of free time to tackle (perhaps you know someone?) and by the time it was completed would need to be redone. 

I know of a couple of marketing types I'd like to nominate.

 

1 hour ago, KHenson said:

p.s. I seriously doubt Greg needed to be educated about SEP. He passed his ACA Cert test (4 times to date) which deals very heavily with SEP. 

That may be, but he didn't know anything about this 2016 Health and Human Services SEP FAQ until I told him. Greg was very upfront about it. I'm curious on your take on how this FAQ impacts a full-timer's domicile.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
DISH TV for RVs

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On 7/16/2018 at 1:27 PM, KHenson said:

Just because a plan is BCBS PPO does not mean it offers nationwide coverage.

I'm all too familiar with insurance plans that offer a PPO but it turns out to be only a local network, with no out-of-network coverage whatsoever.  Obviously these are not a good choice for fulltimers, although some of them do have them because it's their only choice.

I've seen Blue Cross HMO plans that have only a local network, but haven't yet run across a Blue Cross PPO plan that doesn't have access to BCBS's nationwide network.  Or, well, that I could tell from what I was seeing.  Can you point me to a Blue Cross PPO plan that doesn't include the nationwide network?  It doesn't matter which state--I just want to see how it's presented so I will know what to look for.

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I've clarified my chart for you Zulu. Also, we know most fulltime RVers domicile in FL, TX, SD because we have spoken with/assisted thousands of them over the past 5 years. I understand that may be changing but it's a slow change so far. 

Blues, I don't know of any specific BCBS PPO plans that do not cover nationwide but there are many other PPO plans that don't as you know. But I also don't know of any in areas where there are a large population of RVers domiciling (although Florida Blue EPO works like a PPO out of state).

Kyle Henson, Fulltime RVer since 2011

Founder/Former Owner of  RVer Insurance Exchange

 

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  • 2 weeks later...

I thought I had read that they are going to allow trade associations to offer coverage.  Also a that plans will no longer have to have the minimum essential benefits for ACA compliance.  That would allow a major medical plan that was affordable like I had before the ACA and it was an individual $10,000 deductible with Humana that covered me everywhere.

 

 

 

 

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  • 2 months later...

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