In a perfect world, insurance buyers would understand their products just as well their insurance agents. This would save a few headaches for everyone involved, and it would probably streamline the process on all ends. However, the reality is that most business owners don’t understand the extent of the insurance products they purchase. Then again, no one should expect them to. Insurance products are highly complex vehicles. Few business owners have the time to invest in becoming experts in the field or in the products they purchase. Even the best insurance agents spend years learning about the products they sell, many of which change frequently as the economy changes. That being said, no business owner should simply buy a product without understanding the most important aspects regarding what it does and does not cover. In truth, a highly skilled insurance agent should never let them, either. Here’s where there can be a gap between how much insurance a business purchases and how much it actually needs, showing why educating business owners on the extent of their insurance really matters. False Perceptions of General Liability Are Common Many customers tend to believe their insurance covers more than it actually does. This situation could probably be applied to any insurance product, but general liability policies are often the most frequently misunderstood by buyers. See also: What to Expect on Management Liability   To put it simply, far too many businesses are purchasing less insurance coverage than they should. In a sense, many are taking a huge gamble, believing their risk exposure is less than what it actually is or that their preventative measures, such as employee training, can shield them from those risks. While risk prevention definitely helps, it’s ultimately far from the bulletproof shield many companies think it is. Most companies do it to help themselves get a better rate on their insurance, while maintaining the false perception that their general liability coverage protects them against a multitude of risks not actually defined in the policy. As a company scales in size, so, too, does its likelihood of experiencing losses related to cyber liability, employee fraud, fiduciary liability, directors and officers (D&O) or workplace violence. Yet many companies seem not to realize their exposure. This would, of course, be less troubling if companies were purchasing policies that actually covered those kind of risks. Overwhelmingly, they’re choosing to avoid those insurance products altogether. According to Chubb’s survey on private company risk, non-purchasers believed their general liability policy covered:

• Directors and Officers Liability (65%)
• Employment Practices Liability (60%)
• Errors & Omissions Liability (52%)
• Fiduciary Liability (51%)
• Cyber Liability (39%)

Businesses aren't failing to purchase enough liability coverage because they’re unnecessary risk takers. Most, it seems, simply have false perceptions about what their general liability will and won’t do. A small business may think its general liability policy covers a server hack. Yet, lo and behold, when a server gets hacked and the ensuing liability claims start pouring in, that small business may quickly find itself underwater. In fact, the U.S National Cyber Security Alliance found that the 60% of small companies went out of business within six months of a cyber attack. This seems extreme, but the average cost for a small business to clean up after a hack is $690,000, according to the Ponemon Institute. How many small- or medium-sized businesses can easily absorb that kind of cost without insurance coverage? Not many. Similarly, mid-sized companies may believe their general liability policy covers directors and officers, leaving the company with unnecessary risk exposures should an incident occur. If, for example, a company begins operating internationally and fails to effectively meet one of the federal regulations governing its industry, a general liability policy won't help protect the company from impending lawsuits. Any directors held personally responsible may find their own personal assets at risk. Given what we learned from the Chubb survey, it’s quite likely that most directors may think they’re fine with the minimal coverage they receive from a general liability policy. A costly mistake, to be sure. Who’s to Blame? We’ll leave the finger pointing aside for now and settle on this: The customer is always right, but he’s not always well-informed. As every insurance agent knows, the amount of time it takes to fully understand an insurance product can be extensive. Business owners, in general, lack the time to invest in fully understanding the products they purchase. It should come as no surprise, then, that misunderstandings arise over what general liability policies actually cover and what risks they simply won’t mitigate. See also: ISO Form Changes Commercial General Liability   Insurance agents have a responsibility to use their knowledge to help business owners better understand and sift through those misconceptions. More needs to be done to help decision-makers understand what they are and are not getting from their insurance. Helping businesses better understand the ins and outs of their general liability policy is a win-win all around.

Surveys suggest that less than 25% of small business has any form of risk management plan beyond the purchase of insurance. A considerable percentage of business risks aren’t insured, and, even for those that are, lack of appropriate cover and underinsurance remain a perennial issue. Most small businesses have shallow pockets, meaning the cost of a loss can often be business-ending, especially where there isn't enough insurance or risk contingency planning in place. Cost and complexity are cited as primary reasons for businesses not developing a risk management plan. This is hardly surprising given the range of risks an average business can be exposed to, not to mention the myriad of other operational activities necessary to run a successful business. The problem for businesses is made even more complex as some risk areas, particularly emerging risks such as cyber, may or may not be covered by a variety of different insurance policies. See also: Risk Management, in Plain English   Insurance carriers have vast amounts of business risk management expertise, but typically this is targeted at the larger or more complex risks that an insurer covers. But this risk management expertise can be mobilized to customers in a cost-effective and efficient way through digital risk profiling, enhancing both the ability of a business to manage risk and of insurers to recognize active risk management in their pricing. Until now, most of the technology supporting risk has been designed, and priced, to only appeal to larger organisations. RiskAdvisor has built a platform to enable insurers to cost-effectively mobilize their risk expertise to both enhance business best practice and form deeper relationships between a business, its intermediary and its insurer to reduce the cost of risk and boost the resilience of organizations. Specific benefits to insurers include:

• Risk assessment – ability to analyze business- and industry-specific risks, producing a risk profile to support better decision making.
• Optimal insurance coverage – enabling the more intelligent matching of risk and insurance to reduce the risk of being underinsured.
• Much greater resilience for insureds to recover from loss events.
• Improved governance and compliance outcomes.
• Confidence to key stakeholders such as financiers and equity providers.
• Collaboration with intermediaries to help them become trusted risk advisers, building strong relationships with their customers and providing value-added services.
• Ability for business partners to enrich partnerships with key stakeholders such as customers, suppliers and financial institutions.

See also: Key Misunderstanding on Risk Management   To see how RiskAdvisor works, you can find a video here. Here is a sample of industry- and risk-area-specific exposure and control checklist from RiskAdvisor system:

SUMMARY: Like a chief executive hired to turn a failing company into a profitable one, president-elect Trump has said he will take an unflinching corporate approach to overhauling the U.S. healthcare system. For an industry that prefers stability to surprises—and one that has worked to adapt to the Affordable Care Act—Trump’s “repeal and replace” agenda may create new uncertainty and opportunity for healthcare leaders. President-elect Donald Trump will likely enter the White House seeking to “repeal and replace” the six-year-old Affordable Care Act (ACA). While the law has reduced the number of uninsured people and accelerated the shift to a more value-based healthcare system, it has struggled to lower costs, make care more affordable and win over a majority of Americans. Though complex, full repeal may not be a far reach for the president-elect. And even if Trump falls short of full repeal, he still may have congressional and regulatory paths to more targeted changes. For example, Trump could push Republican senators to defund the consumer exchange subsidies in a budgetary maneuver known as reconciliation. If successful in repealing the ACA, Trump said he would implement long-held Republican policies, plus a few new to his party’s thinking, designed to shift control of the $3 trillion healthcare industry away from the federal government and toward private enterprises, state governments and consumers. To push through his platform, Trump will likely have to navigate mounting pressure from macroeconomic forces— including rising healthcare expenditures and challenging Medicare financial and demographic projections—that may affect how he approaches his health reform agenda. Trump will likely need to mend relationships with congressional lawmakers—including Republicans who drew fire from him on the campaign trail. Consumers’ expectations for the evolving U.S. health system may also affect the Trump administration’s ability to negotiate with policymakers. Americans view healthcare as a top issue. While the candidates did not make healthcare a top-tier priority until the last weeks of the campaign, 76% of consumers told PwC's Health Research Institute (HRI) that it is important to them. For Trump, the challenge will likely be making healthcare more affordable for consumers while offering plenty of choices. In interviews with HRI, health industry experts said they viewed Trump as a corporate chief executive—an image he projected on the campaign trail. As such, the Trump administration is more likely to rely on free market levers, such as price transparency for providers and open negotiations with pharmaceutical companies, than the traditional regulatory process. This approach could benefit consumers by giving them the tools they need to shop around for their care. See also: What Trump Means for Healthcare Reform   “The refreshing part of it is he is bringing in completely new people, and, presumably, they will re-evaluate everything that’s been done in terms of policies and building for the future,” said Chip Kahn, president and chief executive of the Federation of American Hospitals, a Washington, DC-based association that represents for-profit health systems. For this report, HRI interviewed healthcare advisers and association executives to gain a clearer understanding of how Trump’s presidency will likely affect the industry. HRI also surveyed American consumers about healthcare policy issues that may emerge under the new administration. HRI assessed Trump’s proposals as he presented them during campaign speeches and on his campaign website from July through November. Trump’s health policy priorities: From “repeal and replace” to “the art of the deal” During his campaign, Trump promised to immediately repeal the ACA. He also unveiled a multi-point plan to overhaul the U.S. healthcare system, aiming to lower the cost of care through market, tax and legal reforms. His proposals include the expanded use of health savings accounts, cross-state insurance sales, increased transparency around provider prices and re-importation of medications, as well as allowing Medicare to negotiate with drug makers, giving tax credits to individuals who pay out-of-pocket for their care and block-granting Medicaid. HRI conducted an analysis of Trump’s proposals based on industry, consumer and congressional sentiments toward the president-elect’s policy goals (see figure 1). Repeal of the ACA would greatly affect the healthcare industry Repealing the ACA would be a major change to the current healthcare system, which has spent much of the past six years implementing its many moving parts. The industry has learned to live with and even, in many cases, embrace the law. Industry executives have questions about the implication of Trump’s policies to replace the ACA, which could increase the deficit in the long run and the number of uninsured by almost 20 million people, according to a Commonwealth Fund study.  Employers, who complained about the administrative costs of implementing the ACA, could find themselves spending money on changing employer policies and data systems to implement laws meant to replace the ACA, if it were repealed. Repeal also ends popular ACA provisions, like the guaranteed issue of insurance, allowing young adults to remain on their parents’ health plans until the age of 26 and filling in the Medicare Part D donut hole. It is unclear from his proposals whether Trump would try to keep any of these ACA provisions intact. The industry has other concerns about repeal, which would mean an end to revenue and tax provisions, including tax credits to offset premium costs. Medicaid expansion also would presumably be reversed, as would care delivery reforms that accelerated the move away from traditional fee-for-service payments to ones focused on quality and outcomes. "‘Repeal and replace’ could be very tough on hospitals that worked in the last process in 2009 and 2010 to accept tremendous Medicare and Medicaid reductions to help health reform happen,” Kahn said. “It would be important for us to see if those two things go together. If you want to repeal, fine, but you have to repeal the whole thing. And that’s going to be hard.” If attempts to fully repeal the ACA fall short, however, Trump and Republicans in Congress have other tools they can use to dismantle the law, including the use of reconciliation and the appropriations process, where Congress may be able cut spending to ACA programs. Some of those taxes have proven unpopular with health industry leaders. Under Trump, ACA foes in Congress now have an ally who is likely to push to remove those provisions. Beyond repeal, Trump embraces a free-market approach to healthcare Trump views healthcare as an industry that should look and feel like other industries, complete with market competition and consumer choice. From that perspective, Trump likely will first use traditional open-market levers to affect prices, a move that may be well-received by the public. According to the HRI survey, 62% of consumers said lowering the cost of health services should be a priority for the new president. Trump likely will look to build on the momentum toward more transparent pricing in healthcare. Some of it is rooted in the ACA, which requires hospitals to make public their lists of charges for medical procedures. Some states, such as Ohio and Florida, already have passed price transparency laws that take the ACA’s provisions further. The push for more transparent pricing is reflected by a growing number of consumers across the U.S. who are beginning to shop around for medical services. In 2015, 30% of consumers said they had contacted providers about prices, according to a survey conducted by HRI.  In turn, some hospitals and health systems have started offering more retail-like experiences around pricing, with at least one system offering to refund a portion of costs if patients are unhappy with their care. Trump also said he aims to expand consumer use of tax-advantaged health savings accounts, or HSAs. HSAs would be allowed to be handed down from family member to family member. Sixty-two percent of employers already offer HSAs, while 21% are considering offering them to their employees. See also: What Trump Means for Business   Despite the wide availability of HSA plans, U.S. consumers have been slow to adopt these tax-advantaged accounts. That may be changing. According to a 2015 report by America's Health Insurance Plans (AHIP), HSA plans participating in an AHIP survey experienced a 22% increase in enrollment between 2014 and 2015. The art of the deal: What works in business may be challenged by Congress On the campaign trail, Trump mentioned his skills as a business negotiator as crucial to how he would push through his policy agenda once elected. Trump may need to fine-tune his pitch to Congress if he wants to push through major parts of his health reform agenda, including giving Medicare the power to negotiate directly with drug makers and allowing the re-importation of prescription drugs. Both proposals have been stalled in the past. Determining Medicare’s power to negotiate with drug makers has been difficult to define because Medicare deals only with private insurers, which design and sell Medicare Part D plans and already negotiate with manufacturers. And, drug safety is a looming concern with re-importation. Even allowing insurers to sell coverage across state lines could face obstacles. Trump has positioned the idea as a way to lessen regulatory hurdles, lowering the cost of coverage for consumers and decreasing administrative burdens for insurers. But under a repeal scenario, there could be wide variations in how much insurers could charge enrollees and differences in benefits and premiums from plan to plan. Cross-state insurance sales may better meet the needs of younger and healthier individuals and lower standard benefit requirements, but it could also leave some consumers susceptible to higher out-of-pocket costs or lack of coverage for serious conditions. Trump also has proposed giving consumers tax credits to defray the costs of their coverage. However, the costly proposal, estimated at $41 billion, would likely require spending offsets. Under repeal, providing tax credits in the individual market could undermine employer-provided health insurance and increase the number of uninsured. Trump’s plans for Medicaid include turning it into a block grants program. A 2015 block grant proposal by House Budget Committee Chairman Tom Price found that it would reduce federal funding by $913 billion over 10 years. But the result could mean the loss of coverage for some people, a reduction in Medicaid benefit coverage or both. A major change in Medicaid, especially one that is intended to reduce federal spending, is likely to be opposed by the states that expect the largest losses from the proposed block grant program. Trump also has said he may favor expanding Medicaid. This expansion likely would mirror the efforts by Vice President-elect Mike Pence to expand the program in Indiana through a waiver that reflected more GOP-leaning principles. The Healthy Indiana Plan requires individuals to pay into a “personal wellness and responsibility account,” which is used to cover a $2,500 deductible. The state pays a majority share, but individuals also are on the hook for some amount. If an individual’s healthcare expenses are less than $2,500 in a year, the balance rolls over to the next year. Enrollees also can take additional reductions if they complete wellness programs and use preventative services. This model, with its personal responsibility flavor and focus on HSAs, might be popular with state Republicans. But not all waiver programs succeed. The Department of Human and Health Services (HHS) has denied some states' Medicaid waivers. The federal government turned back Ohio’s Medicaid proposal because it required increased cost-sharing for beneficiaries and would have led to dropped coverage for those who could not pay. Yet these types of denials could change under a Trump presidency. Macroeconomic healthcare trends will challenge the new president Complicating Trump’s efforts are broader macroeconomic healthcare trends. Discussion of these forces was virtually non-existent on the campaign trail. But if Trump does not take steps to tackle these economic issues, he may have a hard time advancing his healthcare platform without reductions in mandatory spending on major health entitlements (see figure 2). Mandatory spending on major health programs, such as Medicare and Medicaid, coupled with Social Security, are expected to account for 88% of the growth in federal spending over the next decade. The remaining 12%, the discretionary federal budget, which pays for such programs as defense, education and transportation, will likely be crowded out by healthcare spending. Unless Trump is willing to accept large increases in the federal deficit, he will likely be forced to look for ways to significantly reduce healthcare spending to make room for other domestic priorities. In addition, the Medicare Hospital Insurance Trust Fund, or the Part A trust fund, will be depleted by 2028, according to actuaries at the Centers for Medicare and Medicaid Services (CMS). The Medicare program is very popular with Americans. More than 70% of consumer survey respondents told HRI that it is an important policy issue. The federal government won’t let either program become insolvent. Medicare is the nation’s largest payer of healthcare services. It sets policies that are replicated throughout the industry. But the new administration will likely face significant pressure to tamp down healthcare spending. From an industry perspective, providers and other parts of the healthcare sector may have to defend against proposals to slow Medicare growth by cutting their reimbursements. The persistence of uninsured individuals is another unresolved issue for Trump. Although the number of uninsured Americans is at a historic low, 8.9%, so roughly 28.4 million people still lack coverage. The ACA exchanges have fallen short of earlier projections for enrollment (see Figure 3). Moreover, 19 states have yet to expand Medicaid to the levels set out in the ACA. The number of uninsured is expected to grow to about 50 million people with "repeal and replace." Trump’s challenge will be to lower that number through his replacement proposals. Medicare reform also looms large on Trump’s agenda. The new administration will be in charge during the first year of MACRA, the Obama administration’s overhaul of physician Medicare reimbursement. With MACRA, Medicare will double down on the shift from volume-based payments to value-based care. Trump likely will support the continued move to value-based care, which, in part, pushes hospitals, health systems and other parts of the industry to operate more like retailers. But the savings results from value-based reforms have been mixed, which means hospitals, physicians and health systems can expect more tinkering in their reimbursement programs. Implications for the health sectors Trump’s health proposals would touch nearly every corner of the U.S. healthcare system. In keeping with his background, his approach likely will be more business-oriented. This could mean allowing the health sectors to operate with a freer hand and without overly burdensome regulations, or it could take the form of Trump delegating much of the health policy work to his administration. See also: What Trump Means for Workplace Wellness   HRI analyzed the impact of Trump's proposals on the U.S. health sectors based on interviews with internal firm experts and external policy influencers. Proposals were taken from Trump’s campaign website, which HRI accessed multiple times between July and November. Conclusion Trump’s candidacy raised more questions about his healthcare proposals than it provided answers. This uncertainty—if not addressed early in his tenure—could frustrate industry players, new and established. They will likely be looking for clear direction on how they should proceed. This uncertainty could stall efforts to shift to value-based payment models. Trump’s corporate business tools will likely be challenged as he attempts to reshape the U.S. health industry, which does not operate like a typical business sector. “Repeal and replace” of the ACA may be difficult. Experts estimate that it could substantially increase the number of uninsured, reduce revenues to the healthcare sector and potentially drive up the federal deficit. These economic uncertainties place significant cost pressures on industry stakeholders. The replacement proposals outlined address a patchwork of issues but not the loss of coverage that would result from a repeal of the law. Overall, Trump’s proposals present a new set of challenges and opportunities for an industry that already faces uncertainties over a burgeoning New Health Economy. You can download the full report here. It was written with Kelly Barnes, Bob Valletta and Mike Swanick.

What do you do when you see the need for a big change? Unfortunately, both in business and in life, we tend to do nothing. In a smart new book, The Wisdom of Doing Things Wrong, Ron Donovan offers insights on why this happens, how to get past the natural human preference for familiarity over change and how to engage others in effective change. Donovan believes that people and organizations often don’t start down the path of real change because they are afraid of getting it wrong. Instigating big change is like standing in the river and attempting to change its course. The current of majority opinion will destroy most who attempt it. The fear of failure, of looking silly, of wasting time and money, of using up the good will of others is enough to dissuade most potential agents of change. See also: A Management Guide to Omni-Channel   This is not your typical change management book. There are no PowerPoint slides, no two-by-two matrices and no data crunched from cross-organizational studies designed to generate big consulting engagements. Instead, Donovan offers a series of personal stories. Some are emotional. Some are prescriptive. Some stories encourage readers toward personal introspection—how they can be their own best friend or worst enemy. Some stories help readers think about working with others—how small changes in how they act toward others might change the world. Some stories deal with working in organizations—including how to know whether an organization will never change. Running throughout the book is the argument that big change is almost impossible but that effective change is not. Effective change is a lot of little change happening so quickly it looks like big change. That is why Donovan believes there is wisdom in doing things wrong. Change always feels wrong. Like brushing your teeth with your other hand when you have a broken wrist, the only way to push through an unworkable present toward potentially better futures is by doing new and uncomfortable things. Here is Ron Donovan’s model for any big change:

Pick a small piece of a big problem and work on it. Then, even if you haven’t completely finished, add another small piece. A lot of people doing this is what is necessary to deliver huge results.

Donovan attempts to show through his stories that we all know how to do this. It is simple enough that you do not need consultants. You do not need to send people away for education. You do not need to spend a lot of money or time before you start. All you have to do is to begin where you are. In this, Ron Donovan’s simple, straightforward approach is consistent with that of Thomas Watson, Jr., the legendary CEO of IBM whom Fortune once called “the greatest capitalist in history.” Here’s how Watson described his management approach to finding a workable balance between inaction and ill-considered decisions:

I never varied from the managerial rule that the worst possible thing we could do would be to lie dead in the water with any problem. Solve it, solve it quickly, solve it right or wrong. If you solved it wrong, it would come back and slap you in the face, and then you could solve it right. Lying dead in the water and doing nothing is a comfortable alternative because it is without immediate risk, but it is an absolutely fatal way to manage a business.

To be clear, both Watson and Donovan's approaches encourage asking tough questions. Neither argues for charging forward on demonstrably bad ideas. See also: 4 Tips: How to Be a Manager, Not a Doer   Both remind us, however, that there is wisdom in doing things wrong.

The management of risk, whether you call it enterprise risk management, strategic risk management or something else, is about helping an organization achieve its objectives. All the standards, frameworks and guidelines talk about risk in terms of its ability to affect the achievement of the organization’s objectives. Typically, reporting to the management team and the board has been in terms of risks, focusing only on the things that might happen (collected together in categories that reflect where those risks might arise) that would be harmful. This allows the consideration of risks but not really how they might affect the achievement of objectives and which objectives might be “at risk.” See also: How to ‘Gamify’ Risk Management   Why not turn the information around and use it to indicate the likelihood that the organization will achieve each of its objectives. For each initiative, what is the likelihood of success? Then we can answer these questions.

• Considering all the things that we have identified that might happen, how confident are we that we will meet the objective (within an acceptable level of variation)?
• What is the possibility that we can exceed it?
• What is the possibility that we will fall short?

The assessment will not only provide valuable insight but will enable decisions to be made that will increase the likelihood and extent of success. The report might look something like this. What this tells us is that so far we are exceeding our target. However, when we consider all the things that might happen over the rest of the period, there is a 15% possibility that we will fall short of the target. (This should be the judgment of the people responsible for running that part of the business and achieving the objective. It is not intended to be the result of a precise calculation.) Leadership can consider whether this is acceptable. Should action be taken to improve the likelihood of success? Leadership can also see that there is a small possibility that the target can be exceeded. What can be done to improve that likelihood without increasing the possibility of falling short? A report like this moves the conversation from focusing on failure to focusing on success. See also: Can Risk Management Even Be Effective?   Such a report changes the discussion to one that resonates with the executive management team, helping them understand how the management of risk can help them achieve their objectives. This is a revolution in a couple of ways:

• It turns the discussion of risk to objectives around 180 degrees to focus on objectives, and
• It demonstrates how the management of risk is of huge value to the organization.

I welcome your comments. Is this an approach that COSO and ISO should adopt as they upgrade their guidance?

Nigerian 419 scams have been around seemingly forever, seducing one victim at a time. But now some veteran 419 con men have shifted their focus to targeting small- and medium-size businesses for systematic thievery that pivots off how SMBs have come to rely on email as a payment tool. Classic 419 advance-fee scams trick one individual at a time into putting up seed capital to help a persecuted Nigerian prince, or some other wealthy person caught in a bind, transfer a large sum into the U.S. The carrot—a promised share of the transferred funds—never materializes, of course. But the new form of attack eliminates the need to orchestrate an elaborate ruse just to dupe an individual victim. Instead, the predators lurk in the shadows of the internet, weasel their way onto business email systems and then wait patiently for opportune moments to intercept funds on the move between two companies. See also: New Attack Vector for Cyber Thieves   The emergence of these attacks demonstrates just how susceptible SMBs participating in the global supply chain are to hackers of modest technical skill. Intelligence about this new technique comes from Joe Stewart and James Bettke, researchers at Dell SecureWorks' Counter Threat Unit, who conducted intensive surveillance on one Nigerian ring, in particular, that has scored big. Waiting for money to flow SecureWorks researchers have observed this gang orchestrate several payment diversions per week, typically stealing $30,000 to $60,000 per caper, including one theft earlier this year of $400,000 that a U.S. chemical company attempted to wire to a supplier in India. “They’ll work on several deals at a time,” Stewart says. “They have plenty of other companies they’ve compromised, so they’ll just go from mailbox to mailbox to see what new deals are coming in and start preparing for the high-end payments.” Stewart says certain members of this ring began years ago carrying out classic Nigerian 419 scams. They’ve progressed to SMB wire fraud by teaching themselves how to apply tried-and-true hacking techniques to payment practices routinely used as part of the global B2B supply chain. How the scam works The gang uses a simple tool to crawl the internet and scrape employee email addresses from corporate websites, Bettke says. Those employees are then bombarded with viral email. The goal is to infect one machine and then use that as a foothold to ultimately secure privileged access to the company’s web email server. Once control of the email server is in hand, daily monitoring for purchase order communiques begins. Preparation of lookalike email, as well as arrangements to wire funds into bank accounts set up to launder stolen payments, also gets underway. See also: Scammers Taking Advantage of Google None of this requires any special hacking expertise; the necessary software and tutorials are widely available online, Bettke says. At the optimum moment, i.e., when a wire transfer payment request is sent through, the gang intercepts that legit request and replaces it with one sent from a lookalike domain carrying instructions to divert the payment to a bank account they control. “All of this communication takes place over email,” Bettke adds. “The attacker is essentially doing digital check washing, taking that invoice and just changing the destination bank account details to divert the funds.” Bracing for more attacks SecureWorks turned their findings over to international law enforcement, specifically the Economic and Financial Crimes Commission, as well as Nigerian authorities. No arrests have resulted yet. Stewart expects variants of this type of attack to scale up in the months ahead, thanks to the low entry barrier, comparatively low risk of getting caught and high monetary gain. This means any organization that has come to rely on email communiques to carry out high-dollar wire transfers should be on high alert. A thorough assessment of how your organization uses web email is the first step, and deeper due diligence is definitely in order. This article originally appeared on ThirdCertainty.

On Tuesday, Nov. 8, 2016, the majority of a major minority of the people in this country opened the window, stuck their heads out and yelled just as Howard Beale instructed in Network: “I’m mad as hell, and I’m not going to take it anymore.” The rest will be history. Power to the people! As you and your organization move from yesterday, through today (2016) to tomorrow (2020), will you complete this “first term” into the future, be thrown out before your term is complete or be reelected by a landslide? The choice will be made by the marketplace. Your performance is determined by your clients and prospects -- your voters -- not your measurements of “best practices” and “peer studies.” Best practices are the judgment of our peers comparing us with our “superior” peers. Best practices are inside baseball. They're all about us – our industry. In Tuesday’s election, despite all the best practices and peer studies that meant all the media “knew” that Hillary Clinton was the winner – SHE LOST! The media knew she would win not from some impulsive whim but rather through history, polls, the wisdom of the elders of their tribes (Democrats, Republicans, independents) and those who had grown up in the industry of government – lobbyists, consultants, pollsters, elected officials, etc. As a practical matter, 16 of the most successful players in the Republican party scoffed during the primaries at the idea that a reality-TV star should be taken seriously. On the other side, the Democratic party in its arrogance ignored millions of outsiders (the children of their insiders plus many of the alienated members of their tribe) who marched in protest behind and beside democratic socialist Bernie Sanders. See also: What Trump Means for Workplace Wellness   Now do you understand? THE MARKETPLACE HAS CHANGED! Enough about politics. Let’s get back to real life – marketing in a dynamic and divided world. Tomorrow is not about the mass market of yesterday. It is about the narrow niches of tomorrow (left-handed diesel mechanics who smoke, or some other affinity group you’ve never considered), their affinity and your knowledge of and intimacy with them, their wants, needs expertise, culture, etc. I recently worked with a non-profit organization that had it all: good people serving a marketplace that their peers would “die for,” plus a membership group with sophistication, economics and education that any niche would envy. The organization included a successful history of 50-plus years and, unfortunately, the baggage and culture problems that nearly always accompany such success. The organization had become “dumb, fat and happy,” focused internally in their comfort zone, and they had let their finger slip off the pulse of their individual members. These very good folks in this organization had done what far too many folks do after an era of success. They existed in their comfort zone versus working to ensure that their clients were comfortable! Conversations about the “good old days” outnumbered asking “what if,” “what now,” and “what next?” They were looking internally at each other versus at the future! Don’t believe me: Test this on your team! Gather your team or a cross section of your team for a futuring group meeting. Draw a circle large enough to hold the assembled group. Ask them to stand on the circumference of the circle to discuss the future. What will happen? Will most (or all) face each other, or will they turn their back on the “history” inside the circle and look at the possibilities on the horizon? Whether you think the above is silly or provocative, the reality is this: Your current processes are perfectly designed to get the results they are already getting. Twenty-three years ago, I naively suggested we “change the culture.” After I tried this a few times and had my rear end handed to me, I learned that to change the culture you must change the people. But this is a foolish fantasy in a world filled with humans with free will and the ability to sabotage change. (Remember Maxine’s wisdom, “Change is good as long as I don’t have to do anything different.”) I then evolved to a more real model suggesting you work to maximize the results that can be obtained in the culture you have. Now with decades of scar tissue, I know better. In fact, Harvard Business Review in its April 2016 cover story, agreed with me – YOU CAN’T FIX CULTURE; just focus on your business, and the rest will follow. See also: What Trump Means for Business   I’ll wrap up this monologue with three slides from a recent planning retreat that acknowledge that you can’t fix culture -- but that you can do other things:

1. You can’t fix culture, but EACH OF US CAN GROW!
2. You can’t fix culture, but ALL OF US CAN COLLABORATE BETTER!
3. The final slide included seven words and one picture. The picture said it all, with a young woman with a “sad face” looking down and back over her shoulder to a yesterday of hurt and a “happy face” young lady looking up and out at the positive possibilities on the horizon! The words – “IT’S ALL ABOUT WHICH WAY YOU LOOK!”

With the (surprising) election of Donald Trump as America’s next president, I’ve been asked by quite a few folks what this might mean for the Patient Protection and Affordable Care Act, especially as it relates to individual health insurance. It’s been more than seven months since I posted anything in this blog (been busy launching a couple of companies), but I thought I’d use this space to provide my perspective. For the impatient among you, that answer is: either a complete disaster or some modest fixes that actually improve the ACA. Dramatic, but non-lethal, changes are unlikely. As for the details: Trump’s call to repeal and replace the ACA was core to his campaign. His official health care reform platform promised to:

1. Repeal Obamacare in its entirety.
2. Permit the sale of health insurance across state lines.
3. Allow individuals to fully deduct their health insurance premiums.
4. Promote health savings accounts (HSAs).
5. Require all healthcare providers to publish their pricing.
6. Provide block grants to states for Medicaid expenses.
7. Remove barriers that delay the introduction of new drugs.

Some of these ideas, such as promoting HSAs and increasing pricing transparency, have merit. Some, like enabling carriers to sell across state lines, are nonsensical for several reasons I have described previously. None offer much solace to the 20 million-plus consumers in danger of losing their individual coverage if the ACA is repealed. Trump and his Republican allies in Congress will need to do more. See also: What Trump Means for Workplace Wellness I hesitate to predict how Trump will lead as president, but he seems to be  a “big picture guy” who leaves details to others. So let’s assume he lets Congress take the lead on repeal and replace. In December 2015, Republicans in Congress passed legislation aimed at gutting the ACA. President Obama vetoed the bill, but its major provisions are instructive:

1. Repeal the federal government’s authority to run healthcare exchanges.
2. Eliminate premium subsidies available to individuals purchasing through the exchange.
3. Eliminate penalties on individuals for not buying coverage and employers who failed to offer their workers health insurance.

Combined with Trump’s campaign promises, these elements of the Republicans’ repeal-and-replace legislation give a glimpse to the starting point of GOP-style healthcare reform. Add House Speaker Paul Ryan’s call earlier this year for high-risk pools, and the hazy outlines of a possible reform package begin to emerge. Given Trump’s commitment to start the repeal-and-replace process on the first day of his administration and Senate Majority Leader Mitch McConnell’s statement after the election that getting rid of the ACA was “pretty high on our agenda,” healthcare reform is coming — and soon. Whether the result will be an outright, actual repeal of President Obama’s signature legislative accomplishment is no sure thing. Supporters of the ACA are already vowing to defend the law. And while Republicans will hold majorities in both chambers of the new Congress, they are a long way from having 60 votes in the Senate. And that’s problematic. Senate filibuster rules require 60 votes to cut off debate and allow legislation to come to a vote. This means the most powerful person in Washington on healthcare reform may not be President Trump, Speaker Ryan or Senator McConnell, but the senator needed for that all-important 60th vote. Yes, the first through 59th supporters are important, but their support means little if a 60th vote is not found. As a result, the 60th senator can have a tremendous impact on the final language in the bill simply by offering (implicitly or explicitly) a favorable vote in exchange for whatever is important to that senator. In 2017, the 60th senator for repeal and replace will be a Democrat. A Republican is expected to win Louisiana’s run-off election, giving the GOP 52 seats in the upper chamber. Assuming Republicans vote as a block — something they’ve become quite adept at in the past eight years — eight Democratic votes will be needed to end a filibuster. The requests of each of the first seven will need to be considered and addressed, but it’s the demands of the eighth senator, that 60th vote, that ultimately matters. Unless … The Senate can temporarily eliminate the possibility of a filibuster against a bill under the rules of budget reconciliation. However, reconciliation bills must address the federal budget, a vague definition that Congress has interpreted with varying strictness throughout the years. Clearly, eliminating funding for exchanges, taxes and monetary penalties affect the budget. Much of the ACA, however, doesn’t. For example, requiring carriers to issue individual policies to all applicants regardless of their health conditions (what’s called “guarantee issue”) has no impact on the budget. The situation in the Senate creates dangerous possibilities. Just one example: Republicans use the reconciliation process to eliminate penalties paid by consumers who fail to purchase health insurance but not the guarantee issue requirement. Under this situation, few consumers — especially young, healthy consumers — will likely obtain coverage until they get sick or injured. This adverse selection would be cataclysmic, and few, if any carriers, would want to participate in such a market. After all, insurers are in the business of spreading risk across a broad population. Guarantee issue without an obligation to buy coverage guarantees a concentration of risk across a narrow population. See also: Why Can’t U.S. Health Care Costs Be Cut in Half?   President Trump can significantly affect the Affordable Care Act through executive orders, but the risk is the same as a partial repeal through legislation. The ACA is a multi-faceted construct with interlocking pieces. The wrong changes can cause devastating unintended consequences. Republicans in Congress and President Trump may not care. The ACA has taken on nearly mythic proportions as the symbol of all that is evil with the liberal, big-government side of politics. However, making careless changes would not only be irresponsible, it would risk the wrath of millions of voters tossed out of the individual market. Those votes matter. Keep in mind, Trump’s election was close. He lost the popular vote. His leads in Wisconsin and Michigan add up to a combined total of less than 40,000 (as of today). Yet failing to repeal Obamacare after making it so central to their 2016 campaigns could be a political disaster, as well. Republicans jumped on replace and repeal in 2010, and over the past six years this position helped deliver durable GOP majorities in both houses of Congress. Many in their ranks may not care about the consequences of dismantling the law. Assuming a desire to address healthcare reform in a responsible way will require the help of at least eight Senate Democrats. Fortunately for Republicans, 10 Democrats have an incentive to responsibly neutralize the ACA issue in 2017. All are up for election in 2018 and hail from red or nearly red states.

• Sen. Tammy Baldwin of Wisconsin
• Sen. Bob Casey Jr. of  Pennsylvania
• Sen. Joe Donnelly of Indiana
• Sen. Heidi Heitkamp of North Dakota
• Sen. Tim Kaine of Virginia
• Sen. Angus King of Maine (officially an independent, but he caucuses with Democrats)
• Sen. Joe Manchin of West Virginia (and arguably the most conservative Democrat in the Senate)
• Sen. Claire McCaskill of Missouri.
• Sen. Debbie Stabenow of Michigan
• Sen. Jon Tester of Montana

The important question, then, is not what Republicans want to replace the ACA with, but what will it take to get enough of these senators to come along? The task could be extremely difficult if new Senate Minority Leader Charles Schumer doesn’t make it politically impossible for many of these senators to break ranks. Republican then have two choices:1) Go nuclear and gut the ACA through the reconciliation process, but keep in place market reforms like guarantee issue; or 2) pass something palatable to eight Democrats, but which they sell as “repeal” to their base. Clearly the first option is irresponsible, but these are not necessarily responsible times. Nuking the ACA will appeal to many in the party, both in Congress and in their districts. The more responsible choice, repealing the ACA in name only, makes the law more palatable and workable. This last point is critical: once they repeal and replace the ACA, the GOP will own health care reform. It darn well better be clear by say, October 2018, that the new system is working. Which result — destruction or refinement — is most likely? We’re in a new and wacky world. We’ll find out soon enough.

Donald Trump's stunning win in the U.S. presidential election, together with the election of Republican majorities in both the House and the Senate, has generated a wave of coverage about the deep changes that will surely occur with Obamacare but not nearly as much about what the voting will likely mean for businesses in general and the insurance ecosystem in particular. While there are far more questions than answers, I'll venture a few observations.

The biggest concern is that Trump brings with him enormous uncertainty that could cause a pause in planning for investments, especially given that we are in the year-end budgeting season. Yes, a transition of power at the presidential level always brings uncertainty, especially when the new president is from the other party, but the uncertainty surrounding Trump will likely last longer than usual -- possibly far longer -- for three reasons and could cause significant problems for the economy.

First, while companies plan investments based partly on an incoming administration's policies, it's not at all clear what Trump's policies are in many instances. Often, he said something startling during one portion of the campaign, such as that he planned a 45% levy on goods from China that would start a trade war, but then backed off and let the furor die. Will he try to impose that levy; build a wall that would damage relations with Mexico, one of our biggest trading partners; cut taxes so much that he adds $500 billion a year to the federal deficit? Who knows? He likely doesn't even know at the moment on many issues.

He has expressed some plans consistently. For instance, he expects to lower nominal tax rates on businesses and simplify the tax structure, which businesses will welcome and which congressional Republicans will likely support. Trump plans to invest heavily in infrastructure, which draws mixed reviews among Republicans. He plans to reduce regulation, including defanging a major consumer watchdog group, which businesses generally welcome, though his thinking on regulation could cause consternation on health insurance. (He says he thinks health insurance costs can be driven way down by allowing any policy approved in one state to be sold in other states -- an approach that state regulators would surely resist and that would leave many companies in limbo while the fight played out.)

But even when Trump has been thematically consistent, he has been shy on details or even contradictory -- his campaign simultaneously cited two different versions of his tax plans that were $1.2 trillion apart in terms of how much revenue they would generate over 10 years.

Even under the best of circumstances, it will take many weeks for Trump's team to build out the details of the many policies that an incoming administration needs to have -- and that most have on Election Day. It could be months before the team even gets to the point of starting to turn the policies into legislation.

Which brings me to the second point about the unusual uncertainty surrounding a Trump administration: He doesn't have a team.

He needs to build a team numbering in the thousands to take leadership roles in the vast federal bureaucracy, but he just has the core of a team at this point, which is very late in the game as it's usually played. That core is mostly his family, four politicians and two political operatives. Two of those politicians -- former New York City Mayor Rudy Giuliani and former Speaker of the House Newt Gingrich -- have experience but have been out of office at least 15 years and don't bring sizable organizations with them. The two sitting governors on the team -- Indiana's Mike Pence, the vice president-elect, and New Jersey's Chris Christie -- have access to organizations, though Christie may be hampered by the Bridgegate scandal. The two political operatives -- campaign Chairwoman Kellyanne Conway and campaign Chief Executive Stephen Bannon -- have only modest resources to contribute to a team, and Bannon's organization, Breitbart News, is toxic to many.

Traditionally, the Republican Party would provide the core of the incoming president's team, but Trump has been at war with most of the leaders of his party -- notably not Chairman Reince Priebus -- almost as much as he has with the Democrats. In addition, many politicians will avoid Trump, at least initially, because of the racist, xenophobic and misogynistic things he said during his campaign.

He will surely build a team. The lure of high office will overcome the scruples for many. But the mechanics will likely take longer than normal, and there could be more than the usual sorts of problems getting the people Trump wants in the jobs where he wants them.

My third and final point: Even once Trump builds a team, it's not clear that he really wants one. He has said that he runs his business pretty much as a solo operator, reserving all key decisions to himself, and he certainly ran his campaign that way. He publicly contradicted his vice presidential nominee on a policy matter related to Russia. Trump and Gingrich reasonably often ventured contradictory opinions in public. Conway has said that she sometimes said things on TV to get Trump's attention, because she knew he was watching her on TV and couldn't always get his attention in private.

What will Trump delegate, and which decisions will he keep for himself? Will he be consistent in the division of responsibility? He has said that he trusts his instincts and doesn't read, so how will he manage a bureaucracy traditionally built on careful analysis, detailed briefings and internal debate? Does he have something entirely different in mind?

Those answers aren't yet clear, and they need to be as Trump figures out how to delineate policy and work with an enormously large team for the first time in his life.

This list of three reasons for additional uncertainty actually assumes otherwise benign conditions. It assumes that he controls his worst impulses, even though he surely wants to wreak revenge on or at least belittle so very many people at the moment. It assumes that he doesn't get bogged down in the lawsuits that are either already proceeding (the Trump University fraud trial begins later this month) or that may be filed against him, including by the women who allege he sexually assaulted them. It assumes that no crisis erupts in, say, Syria or in the economy, which could well pose some problems.

For me, the first big test will be whether he can make peace with the congressional leaders of the Republican Party. If he can, then he has the chance of building a team quickly enough to eliminate much of the uncertainty. But that will be tricky. His personal relationships with many of the leaders are awful, and allying with them would mean turning his back on the many supporters who urged him to "drain the swamp" in Washington, by which they meant getting rid of the entire elite, perhaps mainly Democrats but with many Republicans included.

The uncertainty will be with us for a while – and could well cause a pause in investment during a still fragile time for the economy.

Donald Trump's stunning win in the U.S. presidential election, together with the election of Republican majorities in both the House and the Senate, has generated a wave of coverage about the deep changes that will surely occur with Obamacare but not nearly as much about what the voting will likely mean for businesses in general and the insurance ecosystem in particular. While there are far more questions than answers, I'll venture a few observations. The biggest concern is that Trump brings with him enormous uncertainty that could cause a pause in planning for investments, especially given that we are in the year-end budgeting season. Yes, a transition of power at the presidential level always brings uncertainty, especially when the new president is from the other party, but the uncertainty surrounding Trump will likely last longer than usual -- possibly far longer -- for three reasons and could cause significant problems for the economy. First, while companies plan investments based partly on an incoming administration's policies, it's not at all clear what Trump's policies are in many instances. Often, he said something startling during one portion of the campaign, such as that he planned a 45% levy on goods from China that would start a trade war, but then backed off and let the furor die. Will he try to impose that levy; build a wall that would damage relations with Mexico, one of our biggest trading partners; cut taxes so much that he adds $500 billion a year to the federal deficit? Who knows? He likely doesn't even know at the moment on many issues. He has expressed some plans consistently. For instance, he expects to lower nominal tax rates on businesses and simplify the tax structure, which businesses will welcome and which congressional Republicans will likely support. Trump plans to invest heavily in infrastructure, which draws mixed reviews among Republicans. He plans to reduce regulation, including defanging a major consumer watchdog group, which businesses generally welcome, though his thinking on regulation could cause consternation on health insurance. (He says he thinks health insurance costs can be driven way down by allowing any policy approved in one state to be sold in other states -- an approach that state regulators would surely resist and that would leave many companies in limbo while the fight played out.) But even when Trump has been thematically consistent, he has been shy on details or even contradictory -- his campaign simultaneously cited two different versions of his tax plans that were $1.2 trillion apart in terms of how much revenue they would generate over 10 years. Even under the best of circumstances, it will take many weeks for Trump's team to build out the details of the many policies that an incoming administration needs to have -- and that most have on Election Day. It could be months before the team even gets to the point of starting to turn the policies into legislation. Which brings me to the second point about the unusual uncertainty surrounding a Trump administration: He doesn't have a team. He needs to build a team numbering in the thousands to take leadership roles in the vast federal bureaucracy, but he just has the core of a team at this point, which is very late in the game as it's usually played. That core is mostly his family, four politicians and two political operatives. Two of those politicians -- former New York City Mayor Rudy Giuliani and former Speaker of the House Newt Gingrich -- have experience but have been out of office at least 15 years and don't bring sizable organizations with them. The two sitting governors on the team -- Indiana's Mike Pence, the vice president-elect, and New Jersey's Chris Christie -- have access to organizations, though Christie may be hampered by the Bridgegate scandal. The two political operatives -- campaign Chairwoman Kellyanne Conway and campaign Chief Executive Stephen Bannon -- have only modest resources to contribute to a team, and Bannon's organization, Breitbart News, is toxic to many. Traditionally, the Republican Party would provide the core of the incoming president's team, but Trump has been at war with most of the leaders of his party -- notably not Chairman Reince Priebus -- almost as much as he has with the Democrats. In addition, many politicians will avoid Trump, at least initially, because of the racist, xenophobic and misogynistic things he said during his campaign. He will surely build a team. The lure of high office will overcome the scruples for many. But the mechanics will likely take longer than normal, and there could be more than the usual sorts of problems getting the people Trump wants in the jobs where he wants them. My third and final point: Even once Trump builds a team, it's not clear that he really wants one. He has said that he runs his business pretty much as a solo operator, reserving all key decisions to himself, and he certainly ran his campaign that way. He publicly contradicted his vice presidential nominee on a policy matter related to Russia. Trump and Gingrich reasonably often ventured contradictory opinions in public. Conway has said that she sometimes said things on TV to get Trump's attention, because she knew he was watching her on TV and couldn't always get his attention in private. What will Trump delegate, and which decisions will he keep for himself? Will he be consistent in the division of responsibility? He has said that he trusts his instincts and doesn't read, so how will he manage a bureaucracy traditionally built on careful analysis, detailed briefings and internal debate? Does he have something entirely different in mind? Those answers aren't yet clear, and they need to be as Trump figures out how to delineate policy and work with an enormously large team for the first time in his life. This list of three reasons for additional uncertainty actually assumes otherwise benign conditions. It assumes that he controls his worst impulses, even though he surely wants to wreak revenge on or at least belittle so very many people at the moment. It assumes that he doesn't get bogged down in the lawsuits that are either already proceeding (the Trump University fraud trial begins later this month) or that may be filed against him, including by the women who allege he sexually assaulted them. It assumes that no crisis erupts in, say, Syria or in the economy, which could well pose some problems. For me, the first big test will be whether he can make peace with the congressional leaders of the Republican Party. If he can, then he has the chance of building a team quickly enough to eliminate much of the uncertainty. But that will be tricky. His personal relationships with many of the leaders are awful, and allying with them would mean turning his back on the many supporters who urged him to "drain the swamp" in Washington, by which they meant getting rid of the entire elite, perhaps mainly Democrats but with many Republicans included. The uncertainty will be with us for a while – and could well cause a pause in investment during a still fragile time for the economy.