There has been a lot of changes going on at Stateline Senior Services over the past few months. As you know, last year in September, we added Nancy Petronio to our staff as another sales agent. Well, this year we said goodbye to two staff members and hello to one. Wendy McCloskey and Jeanmarie Donovan left us to pursue other interests. While we are sad to see them go, we wish them all the best with their new endeavors. In April, we welcomed Kate McCloskey to our staff. She will be doing a combination of what Wendy and Jeanmarie previously did. Kate will be our Scheduling Coordinator and will also help with Customer Service. You can see her profile on our “About” page on our website. We hope that you, our clients, will join us in welcoming Kate to our team. As always, we appreciate your business and look forward to serving you in the future.
Archive for year: 2015
Keep your nest egg working in your favor with these five tips.
By Kelly Campbell June 16, 2015 | 10:53 a.m. EDT
You have the date set for leaving your longtime employer, and the time frame is one year out. You may have a plan for retirement, but what should you do with your qualified plan?
Many people think of their company retirement plan as an investment they have very little control over – something they can add money to, but that is completely subject to the risks of the market. While this may be true, you really do have more control than you think.
If you are close to your last day of work, you should be proactive and consider following these five steps to keep your nest egg working in your favor.
Get the company match. This should go without saying, but some people are still not putting away enough money to receive their full company matching contribution. Remember: This is free money, but often, you must put away a certain amount to get the full match. For example, most plans will give you a 50 percent match on up to 6 percent of your income. That means if you put away 6 percent, the company will give you 3 percent. Now, instead of only your 6 percent working for you, you will have 9 percent added to your plan.
Max out your contributions. You are in your prime earning years, and it is time to invest accordingly. Just before retirement, people are likely earning more money than they ever have in their lives. Many of their financial responsibilities, like kids at home, college costs and paying off debt have been satisfied. But now that the real money is coming in, it is time to put away as much as you can. The more you have in your retirement plans, the better prepared you will be for your retirement.
Reallocate your investments. If the market were to go into a downward spiral right before you retire, that could devastate your plans of enjoying your golden years. Being this close to retirement, it is time to consider being a little more conservative. Not that you should move all of your portfolio to cash, but you should not take on unnecessary risk in your later years.
Think of it this way: If you lose 50 percent of your funds, you will need a 100 percent return just to get back to where you started. Here is where it gets worse: If you lose 50 percent, and you are taking out 4 percent, you will have to have a 118 percent return to get back to even. That is simply too high of a risk.
Consider rolling over your funds early. Years ago, you had to leave your employer before you could roll over your retirement plan. But over the past few years, the rules have changed. Most plans have a clause that allows you to move your employer plan to an individual retirement account beginning after age 59 1/2.
The reason you may consider this is to have the ability to further diversify your plan assets. While most plans offer you about 10 to 20 different investment options, you will typically have hundreds or even thousands of options in a brokerage IRA. With those choices, you can likely build a much more diversified portfolio. And you want to diversify as you get closer to leaving your steady paycheck. As always, each individual should consider the fees and expenses of each option and consult with their financial advisor before making a decision.
Construct a written retirement plan. Everyone should have a written financial/retirement plan. While you should have this constructed well before you retire, it is never too late to get started.
The retirement plan is designed with the goal to show where you are today and take you out through your mortality. In other words, your plan will take you from today past your life expectancy and tell you whether your money will likely last, how much you can spend and what rate of return you need to retire comfortably. It is very similar to having a road map for a long trip (or a GPS.)
Lastly, the financial plan is important to do before you retire, but it is equally important to monitor each year of retirement. The plan will show you what path you should follow, and you can review it each year to ensure you stay on track.
The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual. There is no guarantee that a diversified portfolio will enhance overall returns or outperform a non-diversified portfolio. Diversification does not protect against market risk.
Kelly Campbell, certified financial planner and accredited investment fiduciary, is the founder of Campbell Wealth Management and a registered investment advisor in Alexandria, Va. Campbell is also the author of “Fire Your Broker,” a controversial look at the broker industry written as an empathetic response to the trials and tribulations that many investors have faced as the stock market cratered and their advisors abandoned their responsibilities to help them weather the storm.
Most people help aging parents with housework and errands, rather than providing financial assistance.
By Emily Brandon
June 12, 2015 | 5:24 p.m. EDT
Many older people start to require assistance with their daily tasks, and adult children often step in to provide this care to their aging parents. A recent Pew Research Center survey of adults in three rapidly aging countries, Germany, Italy and the United States, found that many respondents with at least one parent age 65 or older say their parents need help handling their affairs or caring for themselves, including 25 percent of those in the U.S., 22 percent in Germany and 38 percent in Italy.
The majority of eldercare is provided by family members. Most Americans with an aging parent who needs assistance say they or another family member provided it (75 percent), as do 70 percent of Germans and 73 percent of Italians. Adult children typically do household chores and errands to help their older relatives, rather than providing financial support or personal care. Here are some of the ways working adults are supporting their aging parents:
Running errands. Most adults are more likely to spend time than money helping their parents, the survey of 1,692 adults in the United States, 1,700 in Germany and 1,516 in Italy found. Over half of Americans with an older parent (58 percent) say they have assisted with errands, housework or home repairs in the past year. Individuals in other countries are even more likely to complete errands and repairs for their aging parents, including 68 percent of Germans and 70 percent of Italians. Providing a ride to the doctor’s office or grocery store can be an extremely valuable service to an older relative who can no longer drive. And help with household chores and home maintenance can help to prevent injuries and falls.
Financial assistance. Some adults provide financial help to a parent who is over age 65, including 28 percent of survey respondents in the U.S., 20 percent in Italy and 18 percent Germany. Many adults say they feel a responsibility to provide financial assistance to aging parents when they require it, such as 76 percent of Americans, 87 percent of Italians and 58 percent of Germans. Younger adults under 30 are more likely to feel responsible for helping with a parent’s finances than their older counterparts.
Personal care. Relatively few adults say they provide personal care for their aging parents, such as helping them to bathe or get dressed. Some 14 percent of Americans with a parent age 65 or older say they have helped with daily personal care tasks. This is similar to the 13 percent of Germans who provide personal care for their parents. However, a quarter of Italians say they help their older parents with dressing and bathing.
Paid help. Bringing in personal care aids for older relatives is somewhat rare. Only 13 prevent of Americans say paid help is the main source of care for their aging parents, and even fewer Italians (9 percent) pay specialists to care for their older relatives. However, over a quarter (28 percent) of Germans say their parents rely mostly on paid help.
The adults who help their older parents generally find it to be a worthwhile experience. Over 80 percent of people who provide assistance to their aging parents in all three countries say they find doing so to be rewarding. A third or less of people providing eldercare in each country report that they find caring for their parents to be stressful.
Emily Brandon is the senior editor for Retirement at U.S. News. You can contact her on Twitter @aiming2retire, circle her on Google+ or email her at email@example.com.
Social Security Announces New Online Service for
Replacement Medicare Cards
Available to Recipients with a my Social Security Account
Monday, June 1, 2015
For Immediate Release
LaVenia J. LaVelle, Press Officer
The Social Security Administration introduced the expansion of online services available through its my Social Security portal available at www.socialsecurity.gov/myaccount. Carolyn W. Colvin, Acting Commissioner of Social Security, announced that Medicare beneficiaries can now obtain a replacement card if they have lost, damaged, or simply need to replace it online using a my Social Security account.
“I’m excited about this newest online feature to the agency’s my Social Security portal and the added convenience we’re providing Medicare beneficiaries,” Acting Commissioner Colvin said. “Any my Social Security account holder who misplaces their Medicare card will be able to request a replacement card using their online my Social Security account.”
Requesting a replacement card through my Social Security account is a convenient, cost-effective and secure way to ensure Medicare beneficiaries have a critical piece of identification available when required by medical providers as proof of Medicare coverage. Simply access your online my Social Security account at www.socialsecurity.gov/myaccount and select the “Replacement Documents” tab. Then select “Mail my replacement Medicare card.” After you request a card, it will arrive in the mail in approximately 30 days.
my Social Security is a secure, online hub for doing business with Social Security, and more than 19 million people have created a personal account. Current Social Security beneficiaries can manage their account—change an address, adjust direct deposit, obtain a benefit verification letter, or request a replacement SSA-1099. Account holders still in the workforce can verify their earnings, and obtain estimates of future benefits. In addition to those existing services, Medicare beneficiaries will now be able to request a replacement Medicare card without waiting for a replacement form in the mail.
For more information about my Social Security or to establish an account visit www.socialsecurity.gov/myaccount.
MAY 31, 2015, By ROBERT PEAR
WASHINGTON — The government relies too heavily on advice from the American Medical Association in deciding how much to pay doctors under Medicare, and the decisions may be biased because the doctors have potential conflicts of interest, federal investigators say in a new report.
This reliance on the association, combined with flaws in data collected by the influential doctors’ group, “could result in inaccurate Medicare payment rates,” the investigators said.
The report, by the Government Accountability Office, a nonpartisan arm of Congress, reveals new details of an obscure process that distributes more than $70 billion a year to doctors treating Medicare patients.
Medicare uses a fee schedule and sets rates based on its estimate of the “relative value” of each service. For example, by the government’s reckoning, a hip replacement operation involves more than twice as much work as cataract surgery and about 20 times as much as a routine office visit with an established patient. In measuring work, the government takes account of a doctor’s time and the amount of mental and physical effort and technical skill required to perform a particular service, compared with other services.
Medicare’s decisions ripple through the health care system and directly affect consumers. Medicare beneficiaries often pay about 20 percent of the Medicare-approved charge for doctors’ services. In addition, many private insurers use the Medicare fee schedule as a guide in deciding how much to pay doctors. If Medicare overvalues a particular service, it may create an incentive for doctors to provide more of it, and vice versa.
Critics have complained for several years about the unusual role of doctors in the setting of Medicare’s rates. The report tends to validate some of the criticism.
The Government Accountability Office said Medicare officials usually accepted the recommendations they received from a committee of 31 doctors formed by the medical association and medical specialty societies.
Meetings of the panel, known as the Relative Value Scale Update Committee, are open to the public. But people who attend must sign a confidentiality agreement promising not to disclose information about the discussions.
In developing their recommendations, the report said, “physicians who serve Medicare beneficiaries may have conflicts of interest” because they stand to benefit when the government assigns higher values to the services they perform.
Higher values mean higher payments. Medicare has assigned a numerical value to each of more than 7,000 services and procedures. Officials multiply this number by a “conversion factor” — now about $36 — to determine how much doctors will be paid for a service.
While changes in the value of particular services are not supposed to alter the amount spent by Medicare, they can determine winners and losers, by increasing payments for some services at the expense of others.
Dr. Barbara S. Levy, who has been chairwoman of the medical association’s update committee for the last six years, defended its work and said she did not see any conflicts of interest.
“We are not talking about dollars or money,” said Dr. Levy, a gynecologist. “We are talking about the time and resources that are necessary to perform a procedure, including: How many sutures does it take? And what sort of equipment? And how many minutes of my nurse’s time? And do I need a nurse versus a medical assistant for the safety of my patient?”
“I can’t imagine how anyone other than a group of physicians could provide that kind of expertise,” she said.
Another committee member, Dr. Gregory J. Przybylski, a neurosurgeon in New Jersey, said, “It is very difficult to get information about services being provided unless you ask the people who are actually providing those services.”
Representative Jim McDermott of Washington, the senior Democrat on the Ways and Means subcommittee on health, said: “Medicare certainly needs clinical expertise to appraise the value of doctors’ services, but we give medical specialty societies an undue influence on their own payments. Medicare is a cash cow for specialists and not for family practitioners.”
The American Academy of Family Physicians has long argued that the American Medical Association panel should include more primary care doctors, as well as consumer representatives, employers and health care economists. Press officers for the A.M.A. said the panel had recommended substantial increases for some primary care services in recent years.
Under federal law, Medicare fees are supposed to reflect the time required to perform a service and the intensity of the work, as well as the cost of items like office space, wages, supplies, equipment and malpractice insurance. Medical societies collect data on doctors’ work by conducting surveys of their members.
But the surveys often have low response rates, raising questions about their accuracy, and Medicare officials do not have a way to verify the data, the accountability office said.
Barbara O. Wynn, a researcher at the RAND Corporation who did a separate study commissioned by the government, found that the time required for thousands of surgical procedures was less than Medicare assumed. For example, Medicare assumes that surgeons spend 75 minutes removing a prostate, Ms. Wynn said, but independent information indicated that the time was closer to 54 minutes.
These and other weaknesses in the data “could lead to inflated Medicare payment rates” for some services, the Government Accountability Office said.
The auditors faulted Medicare officials as well as the doctors’ committee. The federal Centers for Medicare and Medicaid Services “does not fully disclose information upon which its decisions were based” and does not follow “a standardized process” to establish the relative value of doctors’ services, they said.
Physician groups “donate over $8 million” a year in services to the update committee, and “hundreds of physicians provide volunteer time,” the report said. By contrast, it said, fewer than 10 people do such work at the federal Medicare agency.
The Obama administration said it was seeking additional data so it could establish more accurate payment rates.
The Affordable Care Act, signed more than five years ago by President Obama, required Medicare officials to reassess the time and effort needed to provide services. Congress in 2014 supplied $2 million a year so the government could collect its own data.
But the Government Accountability Office said the Medicare agency “does not have a specific timeline or plan for using these funds.”
A version of this article appears in print on June 1, 2015, on page A10 of the New York edition with the headline: Federal Investigators Fault Medicare’s Reliance on Doctors for Pay Standards.
APRIL 30, 2015, By KATIE THOMAS and ROBERT PEAR
The heartburn drug Nexium — whose advertisements have long been ubiquitous on television — was prescribed to 1.5 million Medicare patients in 2013, for a total cost of more than $2.5 billion, the largest amount spent on any drug prescribed through the government program, according to data released by Medicare officials on Thursday.
The data was the most detailed breakdown ever provided by government officials about the prescription claims of Medicare beneficiaries. It included information about 36 million patients, one million prescribers and $103 billion in spending on drugs under the program’s Part D in the year 2013, the most recent year available. The data did not take into account rebates that the drug manufacturers pay to the insurers that operate the Medicare beneficiaries’ drug plans.
Although the government has previously released similar data to outside entities — including ProPublica, the nonprofit news group — officials said they decided to make the information available on a public website to encourage experts to weigh in, potentially leading to new solutions for policy challenges, like how to contain costs.
“We know that there are many, many smart minds in this country,” Sean Cavanaugh, a deputy administrator at the Centers for Medicare and Medicaid Services, said in a conference call with reporters on Thursday. “We are excited to unleash those minds and see what they can find in our data.”
The list of the most-prescribed drugs included less expensive generics to treat common conditions like high blood pressure, cholesterol and diabetes. And almost all of the drugs that accounted for the most in spending — Nexium was followed by the asthma treatment Advair Diskus and Crestor, a cholesterol drug — were used in the treatment of common conditions. One exception was the cancer drug Revlimid, the 10th-costliest drug, which was prescribed to 24,600 patients but cost nearly $1.35 billion.
Some of the costliest drugs in 2013 are now available as less expensive generics, or will be available soon. Nexium, for example, lost its patent protection in 2014 and is now available as a generic; Pfizer, which bought the rights to sell Nexium from AstraZeneca, also sells an over-the-counter version.
Nexium treats a reflux condition known as gastroesophageal reflux disease, or GERD, leading Niall Brennan, Medicare’s chief data officer, to quip on Twitter: “One nation under GERD?”
In some ways, 2013 “was a year of relative calm,” David Whitrap, a spokesman for the pharmacy benefits manager Express Scripts, which handles the prescription claims of millions of Medicare beneficiaries, said in an email on Thursday. His company’s analysis of a representative sample of its members showed that total drug spending in Medicare rose 2.6 percent in 2013. A year later, in 2014, spending jumped 13.8 percent, mainly owing to the arrival on the market of high-priced medications to treat hepatitis C.
More recently, insurers and government health care programs have fretted over the skyrocketing costs of so-called specialty drugs, which treat serious and chronic conditions like cancer, rheumatoid arthritis and multiple sclerosis.
Medicare did not provide a breakdown of top prescribers, but an analysis by The New York Times of the data showed that those who wrote prescriptions leading to the highest total drug costs varied widely in their specialty and geography.
Dr. Gavin Awerbuch, a Michigan neurologist, topped the list of high-prescribing Medicare doctors: The analysis showed he was responsible for $16.6 million in total drug costs in 2013, for 1,300 Medicare patients. He was arrested last year after federal prosecutors said he defrauded Medicare of $7 million and improperly prescribed a pain drug, Subsys.
Mark J. Kriger, a lawyer for Dr. Awerbuch, said he could not comment on the data because he had not analyzed it himself.
Dr. Daniel J. Hurley of Beech Grove, Ind., was listed as responsible for more than $10 million of Medicare prescriptions, the fifth-highest total. “I run a large nursing home practice with four doctors and seven nurse practitioners,” Dr. Hurley said in a telephone interview. “All the patients are in my name. All the prescriptions we write, for 11 or 12 providers, are written in my name.”
Some experts and organizations, including the American Medical Association, have cautioned against drawing too many conclusions about high-prescribing physicians, noting that the data does not include information about patients’ medical conditions. “You don’t know anything about those people, and I think that’s an important missing link,” said Juliette Cubanski, associate director of the Program on Medicare Policy at the nonpartisan Kaiser Family Foundation.
Several health care experts said they were intrigued by Medicare’s analysis showing a wide geographic variation in the use of generic drugs by Medicare beneficiaries. In some areas of the country, including Texas, the South and the Northeast, use of generic drugs was relatively low, accounting for between 65 and 76 percent of prescriptions. Other regions, including the Midwest and Northwest, used generic drugs far more frequently.
Caroline F. Pearson, a senior vice president of Avalere Health, a consulting company, said that the geographic differences in use of generic drugs may reflect that some areas of the country have higher poverty rates. Low-income Medicare beneficiaries can qualify for extra help with their prescription drug costs. This assistance reduces their out-of-pocket costs, so they may have less incentive to take generics.
In addition, Ms. Pearson said, low-income Medicare patients “may be sicker and more likely to need newer brand-name medications” for which generic versions are not available.
Sarah Cohen and Griff Palmer contributed reporting.
A version of this article appears in print on May 1, 2015, on page B2 of the New York edition with the headline: Medicare Releases Detailed Data on Prescription Drug Spending. Order Reprints| Today’s Paper|Subscribe
April 16, 2015, BY WARREN SANDERSON AND SERGEI SCHERBOV, The Conversation
In 1985, American Richard Bass accomplished an amazing feat. He had set for himself the task of climbing the world’s highest mountains in all seven continents. In that year, at age 55, he completed the climb of the last of his seven mountains, Mt Everest and in doing so became the first person to climb all seven mountains and the oldest person ever to successfully climb Mt Everest.
But now Mr Bass’s record has been eclipsed.
The oldest person to climb Mt Everest is Yuichiro Miura of Japan, who reached the summit of Mt Everest in 2013 at age 80. And the oldest person to have climbed all seven mountains in seven continents is Takao Arayama of Tanzania who climbed the last of those mountains at age 74 in 2010.
Over time, as life expectancy increases and people become healthier, older people can do things which were previously the domain of those younger. Indeed, no one would be surprised if, within the next decade, both the above records were broken.
Well, perhaps not exactly no one.
People who analyze population aging using conventional measures assume that none of the attributes that are important for understanding aging change over time or differ in localities. But a wide variety of attributes can be used to study aging. An important one for 65-year-olds, for example, is their projected remaining life expectancy. Another one is how well those 65-year-olds can remember things.
Our research findings challenge the view that the only thing that matters in the study of aging is chronological age; we also dispute the idea that the attributes of elderly people do not matter.
We believe that it is time for aging measurements to account for the new reality of today’s old age, including how well the elderly actually function.
Limitations of the Conventional View on Aging
In the conventional view used by most demographers and policy-makers it is irrelevant that life expectancy at older ages is increasing. Such views don’t account for the observation that older people are healthier and are achieving ever higher scores on cognitive status tests than in the past.
And many find no relevance in the fact that people in their mid-80s and beyond will be able to climb the world’s highest mountains in the future. We seek to challenge this misconception.
An analysis of population aging has two aspects. First, based on chronological age, most countries of the world are in the process of growing older. The proportions of populations 65+ years old are increasing. The proportions 80+ are increasing even faster and median ages of the populations are also increasing.
The conventional approach to the study of population aging ends here, but in doing so, it ignores the second and equally important aspect of aging.
Today’s Elderly Are Not Your Father’s Grandparents
The characteristics of people at each age are changing. For example, in 1950, 65-year-old Swedish men had a life expectancy of 13.5 more years. In 2011, their life expectancy was 18.4 years more, almost 5 years longer.
In contrast in 2010, 65-year-old Russian men had a life expectancy of 11.9 more years, which is less than that of Swedish men in 1900. By ignoring changes in the attributes of people and looking only at chronological age, the conventional approach provides a misleading picture of the future.
In a series of articles we show how to incorporate the changing characteristics of people into measures of population aging. In particular, we have defined a new measure called “prospective age.”
Prospective age is a measurement based on the average number of years that people have left to live. We categorize people as being “old” not at age 65, but when people at their age have an average of 15 more years to live.
Using this criterion, a Swedish man in 1900 would be considered old at age 60. In 1960, he would have been considered old at age 63, and in 2010 at age 69. Russian men would have been considered old at age 62 in 1960, about the same age at which Swedish men would have been considered old at that time. In 2010, however, Russian men would have been considered old at age 59, 3 years younger than in 1960. This reflects the mortality crisis in Russia after the dissolution of the Soviet Union.
In our article in PLOS ONE we describe our discovery of a new and counterintuitive aspect of population aging based on those new measures. Using measures of aging based on prospective age, we found that these measures of aging increase more slowly when life expectancy increase is faster.
For example, we looked at what would happen to measures of aging based on prospective age, if life expectancy were to continue to increase at its current pace in many developed countries of around 1.5 additional years of life per decade. We also looked at what would happen if increases in life expectancy were to stop. We found that our measures of aging were lower in the scenario in which life expectancy was increasing.
In other words, if people lived longer, healthier and more productive lives, we would have less to worry about, in terms of population aging, than if they if they lived shorter, less healthy and less productive lives.
Worries About Increases in Life Expectancies
When people think about aging from the conventional perspective, they tend to fear rapid increases in life expectancy for four reasons.
First, rapid increases in life expectancy may affect the sustainability of pension systems. But more and more countries are adopting pension systems that automatically adjust for changes in life expectancy. For this growing list of countries, the challenge of sustaining pension systems has already been successfully addressed. The United States, unfortunately, is not one of those countries, but it could be in the future.
The second fear centers on health-care costs. But health-care costs are highest in the last few years of life and these years occur later as life expectancy increases.
The third fear is that there will be so many seriously disabled people in the future that it will be difficult to care for all of them. The evidence, however, tends not to support this concern because the rates of severe disability at each stage of older age tend to decrease with increasing life expectancy.
The last fear is that when life expectancy increases there will be more people not working. However, simultaneous with the increases in the life expectancy and health of Americans, the labor force participation rates of 65- to 69-year-olds has jumped (according to figures from the US Bureau of Labor Statistics) from 21.8% in 1990 to 30.8% in 2010.
The life expectancy of a child born in a wealthy country today could well be 100 years. By the end of the century, the populations of many of those countries could have median ages above 65.
We need to think about a future in which more than half of the population would be older than the age at which most people retire today. Pension systems, tax systems, educational systems, and labor markets will all have to adjust.
Population aging does produce challenges. It does us no good, however, to misunderstand those changes based on insufficient measurements. It is time for us to understand aging not just on the basis of how many years people have lived, but on the basis of how well they function. When we understand this, we will be in a better position to plan for the changes that we will have to make.
Warren Sanderson is a professor of economics at Stony Brook University. Sergei Scherbov is deputy director of the World Population Program at International Institute for Applie Systems Analysis.
This article was originally published on The Conversation. Read the original article.
U.S. News & World Report: The Unexpected Costs of Medicare
With a little planning, seniors on Medicare can minimize their out-of-pocket expenses.
By Joseph P. Williams Oct. 15, 2014 | 8:00 a.m. EDT
Created in 1965, Medicare was intended to answer growing reports of impoverished seniors languishing or dying because they lacked health insurance. Since then, Medicare has acquired a reputation as the ultimate government entitlement, a system of low-cost, taxpayer subsidized health care provided at the stage in life when retirees need it most.
But the broad-reaching health care insurance system comes with costs that many seniors – including those already using the plan – don’t see until the bills show up. Those out-of-pocket expenses, according to experts, can range from hundreds of dollars in monthly premiums and office visit copays to six-figure bills for surgery and hospitalization for things like joint-replacement operations, a procedure common among older Americans. Read more
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