1. Yes, it has an Isofix mounting which in the US is called "Latch".
2. We cannot currently sell directly into Europe, though we'd love to at some point. If you're a distributor please drop me a line!
292 karma · joined December 26, 2007
2. We cannot currently sell directly into Europe, though we'd love to at some point. If you're a distributor please drop me a line!
2. Ease of Installation (* see below)
3. Bauhaus Design
4. 1-Hand Operation
5. Ease of Cleaning
6. Built in Rocker (a full one)
7. Quiet (* see below)
* Safety > The US regs are pass/fail so lots of seats on the market have mediocre test scores that don't reflect the real danger of severe concussions. For those of you interested in digging into the obscure world of Head Injury Criterion: greater than 390 HIC is linked with severe concussions (Source: Proposed limits for HIC From Kleinberger et al., 1998, and Eppinger et al., 2000.) Kioma seats do a number of things (crumple zones, etc) to create a lower (better) HIC score. By comparison some of the top sellers in the industry are at 600+ HIC.
* Installation > The regs don't have standards that really address this, but the incredible complexity of legacy car seats has led to a lot of installation errors by parents and caregivers. This can lead to some really unpleasant outcomes and injuries. We designed KIOMA to minimize use and installation errors by making things as simple and intuitive as possible. This seat is optimized for lap belt use only (no base required). The companion base has a number of innovations too that make it intuitive and easier to use.
* Quiet > There are no clicking or snapping or button parts that wake a sleeping child (with the exception of the harness buckle). This is the quietest baby car seat made.
I used to know some of the Cybex people (it was a European company), and they congratulated us on beating their best safety scores at the time. Now Cybex is owned by an Asian conglomerate (Goodbaby).
The Kioma difference in materials quality and performance is both quantifiable and qualitative. We have to charge a price that covers our work in design and production costs. But I completely get it if the Kioma seat is too expensive for your preferences.
As a side note, if you want to be blown away by prices check out the $10,000 cribs (https://nurseryworks.net/collections/cribs/products/gradient...), $1000 bassinets (https://www.happiestbaby.com/), and $5000 strollers (https://silvercrossus.com/category/strollers/).
Thanks for the feedback!
Patents > We don't work for free, and we can't buy groceries by giving away years of R&D. Companies are welcome to license our safety innovations, and they know how to reach us. The invitation to do so is on our website.
TOS > Kioma seats come with an industry standard 1 year warranty. The website TOS are different than the product warranty that comes with each seat. Thanks for the heads up though. I'll have the marketing team clarify that.
TLDR: We stack up really well.
1) No flame retardants are used in the upholstery. We worked really hard to meet the flammability requirements with materials that aren't doped in endocrine-disrupting flame retardants. So that was a big win, because that is the largest chemical exposure in legacy car seats (in my opinion) and it is one that the scientific literature is very clear about.
2) The chassis is mostly machined aluminum (powder-coated) and polycarbonate. On the underside of the chassis there are some bracket retention pieces that use a standard cyano-acrylic glue ("super glue").
Pricing > It isn't for everyone. The Kioma seat is like a Maserati, but some people prefer a Ford Taurus. We have to charge a price to cover our production and design costs, and there is a quantitative and qualitative difference in the materials and performance of a Kioma car seat.
It required lots of material science, production techniques, supply chain adjustments, and a surprising amount of software (to model dynamic stress, and to run the robot and CNC trim paths). Once you get to the point you can clearly articulate your BOM and Specs to a manufacturer for MOQ=50, things get a lot easier. At the prototype stage we built everything ourselves, but now we use OEM manufacturers.
We provide this for the most common ICD codes, and will be adding more in the future.
The quote indicates that the employer group was self-insured, and Cigna was the plan administrator. This means that Cigna is not insuring the health plan. Cigna is probably paid a per member per month (PMPM) fee for third party administration (TPA). The actual medical claims and associated costs are directly paid by the self-insured entity (the employer group).
Self-insurance can make actuarial sense for companies with >2,000 employees.
For example, if you are traveling Out of Area (OOA) and skiing in Colorado, and you have a medical emergency, emergency room care is considered In-Network. Any financial responsibility you have under your health plan (coinsurance, copay) should be calculated as part of In-Network.
* If you have an HMO or EPO plan, it is black and white language. If you have a PPO plan, legally it is a bit squishy because of the already provided for out of network (OON) access. BUT - generally - any emergency is considered in network no matter what product you have and where you are.
Source: I work in health insurance at Evry Health (https://evryhealth.com)
A quick internet search for "electrical ablation cell apoptosis cancer" yields a few research articles. For example https://www.frontiersin.org/articles/10.3389/fonc.2020.01235...
Pricing transparency is only one piece of the puzzle. It is a tremendously antiquated industry. Fax is still state of the art -- welcome to the 1980s!
[1] CMS. https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
Pelican was a ground-effect heavy lift aircraft, too. DARPA refused to fund any Pelican developmental work 20 years ago because the “Technology has been demonstrated already” (by the Russians).
I had the privilege of working for the people who did the concept of operations work.
We try to provide on-demand care whenever reasonable and possible. While it increases utilization of things like mental health and telehealth and wellness for us in the short-term, over the long-term it yields benefits in the overall health of the member (especially when considered across a whole population).
> ACA
The ACA brought approximately 40 million net-new insureds into the marketplace who were previously uninsured. It was/is a hugely ambitious law, with (I think) good intentions, that had (to your point) some unintended consequences. Also, many of the initial assumptions going in on the ACA turned out to be far too optimistic.
Personally, I’d love to have what we had as kids in DoD. As a kid in a US-military household, I had the benefit of full healthcare and dental care and vision care. Our great healthcare was paid for by taxpayers who funded the DoD’s budget. Each child, irrespective of their parent’s income/rank/station/race, received great care. Personally, as a society, I wish we could all agree that every child and young adult should receive healthcare without obstacles or payment fears.
The next challenge is non-payment of premium. Lets assume Companies A, B, and C each respectively insure "Hank" respectively for 50%, 25%, 25%. They respectively pay $50, $25 and $25 per month in premiums to PoolingEntity. What happens when any of A/B/C fail to pay a premium? The insurance contract would eventually be terminated for non-payment (after a statutory notice period), and poor Hank would be back to being uninsured.
Technologically, I think it could be done. But the legal, regulatory, and administrative complexity would need to be addressed.
Separately, a great resource for reading up on where/how Americans get their healthcare coverage is the Kaufman Family Foundation. Many Americans have more than one source for their coverage. https://bit.ly/3KazKNN
Yes, we’ll happily white label/license our tech to other insurers, TPAs, etc. We can license tech, and we can also act as a TPA. We built the technology to solve our own problems, but in effect and to your point, we’ve created a platform that others could leverage. If other players want to imitate us or leverage anything we’ve built – great – it’s a business opportunity for us and it helps more people.
If Kaiser calls us and wants to use our software, we’ll take their call ;)
There are models and mechanisms for multiple smaller employer groups to band together. For example, association health plans are common with professional trade groups.
While an interesting thought experiment, no, we have never thought about multiple employers combining and contributing to insure a single individual.
You are correct that the legacy insurance industry struggles with tech and compliance. I've had the fortune (misfortune?) of being a part of writing and managing policy, claims, rating, and other insurance systems. It is common for a large, legacy insurer to have tens of policy systems and tens of claims systems operating in parallel due to many years of acquisitions and mergers.
Technology is a huge part of our cost advantage, but it isn’t the only factor. We also benefit from our product design, underwriting, provider network structure, etc.
Technology automation and efficiency allows us to a) lower G&A about 10 points and pass through the savings to our customers, and b) reduce delays and duplications in care.
The pure technology cost actually decreases for us over time, on a PMPM basis, as we grow membership. Adding new states and products doesn’t require new systems for us. We just have to make some configuration additions. Architecturally, we’ve built a federation of micro-services and we host on a cloud provider (Azure).
“free mental health coverage” -> We combine our network of therapists and behavioral facilities with online digital health solutions that have their own providers. In person therapy is included as preventive care. No copay, no deductible, no limitation. We combine that with targeted digital solutions for specific mental health conditions (burnout, depression, stress management, etc.) These solutions, again, are made available to members usually without any costs (except for very specific programs). Engagement and participation is incentivized and rewarded with cash on their Evry card. We are making an effort to make therapy – of all kinds – accessible, convenient, affordable, and effective (whether digital or in-person).
How did we build our network of therapists? -> Same as the medical providers (see other Q&A in this post). It requires time and “boots on the ground” having conversations, building trust, and creating contracts that avoid the traditional games played by both sides. We’ve had good success getting digital networks to work on PHQ-9 type metrics and outcomes, sometimes with 100% of payment being tied to a tangible improvement by the patient.
Medical + Rx trend: Our trends are a little lower than the published trend figures because of the shifts we are creating through embedded telehealth and telemedicine solutions. For competitive reasons, we cannot disclose exactly how much lower but it is substantial.
Admin cost savings: A regional Blue Cross Blue Shield plan typically spends 12-15% of their revenue on general and administrative expenses (G&A). That number does not include Sales expenses – it is pure G&A. We are confident in hitting 4% or 5% thanks to all the technology we’ve built and automated, and we pass through the savings to our customers.
Controlling provider costs: It’s not all about controlling costs. You’re certainly correct that our rates across the board would be better if we had a large membership base to illustrate how our programs help physicians be successful and encourage broader collaboration on the care coordination efforts that drive better outcomes and higher quality. Sometimes we end up paying more for a procedure. That’s okay and working as intended! Good doctors should get paid more; bad care should be worth less. But even if we pay more for certain care, if outcomes are aligned and the patient is healthier, it will generate a financial return for us across a population. We offer up to 3-year rate lock-in agreements for employers so we can still capture the savings of, for example, reduced readmission even if it doesn’t occur immediately.
Legacy insurer efforts: Legacy insurers are attempting to address the situation, but their patchwork efforts cannot address the fundamental chassis that they are tied to. That legacy infrastructure and broader employment base is not easily transitioned to modern technology, value-based care, and virtual business models. Also, the innovation-based pilots they roll out may impact one market, like a specific city, or a specific market segment, like Medicare membership, and one service, like pain management for arthritis, but they are not necessarily rolling out solutions that impact their whole population. At the end of the day, the current system is not sustainable.
We have “escape” codes to make sure the doctor is not penalized. For example, if there is a risk of embolism or if there is an aneurysm complication during surgery, then the payment reverts to a fee for service. The point is to ensure patient safety and high quality of care, not penalize the doctor for events not in their control.
If the care being sought is highly experimental or risky, we work with physicians to determine if there are centers of excellence that may provide higher quality of care.