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    Why this top fund manager says the best investment this year is ‘the hedge against political cycles’

    A major exchange-traded fund and mutual fund manager finds the winning gold trade isn’t talked about as much as the artificial intelligence trade — but maybe it should be.
    VanEck CEO Jan van Eck thinks the best investment this year is “the hedge against political cycles.” To him, that means investing in gold. 

    “It is quietly the best performing asset this year,” Van Eck told CNBC’s “ETF Edge” from the Future Proof conference in Huntington Beach on Monday.
    Gold hit another record on Friday, its 37th record this year. As of Friday’s market close, it is up 28% since the start of the year.
    Van Eck, whose firm runs the VanEck Gold Miners ETF, expects foreign investments in bullion will continue to give the commodity a boost. It should also help in lifting gold miners higher, which started the year lagging the commodity. But as of Friday, the VanEck Gold Miners ETF has started to outperform, up 31% this year.
    “I think you own both because the miners, if they catch up at all, it’s going to rip,” he said.
    As for the AI trade, van Eck says it’s “amazing” how investors refuse to give up on it.

    “It’s like part of people’s model portfolios, or core portfolios, is to have this tactical overweight to semis. And some of our biggest clients actually bought on the dip over the last week or two,” the VanEck CEO said.
    Last month, his firm launched the VanEck Fabless Semiconductor ETF. It’s a companion to its VanEck Semiconductor ETF that excludes companies that run their own foundries, such as Intel.
    FactSet reports the new ETF’s top holdings as Nvidia, Broadcom and Advanced Micro Devices as of Friday.
    “Why spend billions of dollars on building the chips if you don’t have to?” van Eck said. “Nvidia doesn’t build its own chips. So that’s another kind of investment strategy.”
    Since launching on Aug. 28, the VanEck Fabless Semiconductor ETF is up a half percent.
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    Boeing machinists on picket lines prepare for lengthy strike: ‘I can last as long as it takes’

    Boeing machinists on the picket lines said they have saved money for the strike and plan to pick up temporary jobs to make ends meet.
    More than 30,000 Boeing machinists walked off the job Sept. 13 after a tentative contract was rejected in a nearly 95% vote.
    The strike brought most of Boeing’s aircraft production to a halt and is costing the company $50 million a day, according to Bank of America estimates.

    Boeing factory workers gather on a picket line during the first day of a strike near the entrance of a production facility in Renton, Washington, U.S., September 13, 2024. 
    Matt Mills Mcknight | Reuters

    RENTON, Wash. — Cash-strapped Boeing is facing mounting costs from an ongoing machinist strike as workers push for higher pay. A failure to get a deal done could be even more expensive.
    In the shadow of a factory outside Seattle where Boeing makes its best-selling planes, picketing Boeing machinists told CNBC they have saved up money and have taken or are considering taking side jobs in landscaping, furniture moving or warehouse work to make ends meet if the strike is goes on much longer.

    The work stoppage by Boeing’s factory workers in the Pacific Northwest just entered its second week. The financial cost of the strike on Boeing depends on how long it lasts, though ratings agencies have warned that the company could face a downgrade if it drags on too long.
    That would add to the borrowing costs of the company, already $60 billion in debt. Boeing has burned through about $8 billion so far this year in the wake of a near-catastrophic door plug blowout from one of its 737 Max planes in January.
    Boeing hasn’t turned an annual profit since 2018, and its new CEO Kelly Ortberg is trying to restore the company’s reputation after months of manufacturing crises that have slowed deliveries to customers, depriving it of cash.

    Boeing 737 Max planes sit at the airport in Renton, Washington.
    Leslie Josephs | CNBC

    At the local union office in Renton, machinists were preparing for what may become a lengthy strike: Union members carried in large pallets of bottled water, while someone mixed a giant tuna salad in the kitchen to make sandwiches for workers. Union vans visited demonstration sites around Renton offering transportation to bathroom breaks for workers on picket duty. Burn barrels provided heat for chilly overnight pickets.
    Many workers spoke of their love for their jobs but fretted about the high cost of living in the Seattle area, where the majority of Boeing’s aircraft are made.

    The median home price in Washington state increased about 142% to $613,000 as of 2023, from $253,800 a decade earlier, according to the state’s Office of Financial Management. That outpaces the roughly 55% increase nationally over that period, according to data from the Federal Reserve Bank of St. Louis.
    “We can’t afford [to own] a home,” said Jake Meyer, a Boeing mechanic who said he will start driving for a food delivery service during the strike and is looking at picking up odd jobs such as moving furniture. Meyer said although he’s striking for higher pay from Boeing, he enjoys the job of building airplanes.
    “I take pride in my work,” he said.
    Another Boeing machinist said he has been saving for months, forgoing things such as restaurants and paying three months of mortgage payments early.
    “I can last as long as it takes,” said the worker, who spoke on the condition of anonymity.

    $50 million a day

    More than 30,000 Boeing machinists walked off the job at midnight Sept. 13 after turning down a tentative labor deal in a nearly 95% vote — 96% voted in favor of a strike. They received their last paychecks Thursday, and health benefits are set to end on Sept. 30. A strike fund from the union will soon give them $250 a week.
    The strike is costing Boeing some $50 million a day, according to estimates by Bank of America aerospace analyst Ron Epstein. The strike halted production of most of Boeing’s aircraft, and that is rippling out to the aerospace giant’s vast network of suppliers, some of which have already been told to halt shipments. Boeing is still making 787 Dreamliners at its non-union factory in South Carolina.

    Boeing Machinists union members count votes to accept or reject a proposed contract between Boeing and union leaders and whether or not to strike if the contract is rejected, at the Aerospace Machinists Union Hall in Seattle, Washington, on September 12, 2024. 
    Jason Redmond | AFP | Getty Images

    The battle pits a struggling Boeing against a workforce seeking wage increases and other improvements. Boeing’s most recent offer included 25% general wage increases over a four-year deal and was endorsed by the machinists union, the International Association of Machinists and Aerospace Workers District 751.
    Workers said they were looking for wage increases closer to the 40% that the union had proposed as well as annual bonuses and a restoration of pensions lost more than a decade ago.
    Boeing and the union were at the negotiation table this week, but both Boeing and union negotiators have said they were disappointed with the lack of progress.
    “We continue to prioritize the issues you defined in the most recent survey,” union negotiators wrote to members Wednesday, “yet we are deeply concerned that the company has not addressed your top concerns. No meaningful progress was made during today’s talks.”
    Ortberg, who is just six weeks on the job, announced temporary furloughs this week of tens of thousands of Boeing staff, including managers and executives, on the heels of a hiring freeze and other cost-cutting measures announced this week.
    “During mediation with the union this week, we continued our good faith efforts to engage the union’s bargaining committee in meaningful negotiations to address the feedback we’ve heard from our team,” Ortberg said in a note to staff Friday.
    “While we are disappointed the discussions didn’t lead to more progress, we remain very committed to reaching an agreement as soon as possible that recognizes the hard work of our employees and ends the work stoppage in the Pacific Northwest,” Ortberg wrote. 
    The strike, which includes Boeing machinists in the Seattle area, Oregon and a few other locations, is just the latest in a series of labor battles in recent years that has included actors, autoworkers, port workers and airline employees, all of which have won raises after strikes or strike threats.
    The Biden administration has encouraged Boeing and the union to reach a deal.
    “I do believe that both parties want to get to a resolution here, and hoping to see one that makes sense for the workers and it works for a company that really needs to find its way forward on so many fronts,” Transportation Secretary Pete Buttigieg told CNBC’s “Squawk Box” on Thursday.

    Tight labor market

    Boeing is facing a tight labor market. During the last strike, in 2008, which lasted less than two months, the company was in better financial shape, and there was less job competition in the area.
    One Boeing supplier told CNBC that furloughing or laying off workers would cause problems for months down the road because it takes so long to train staff on such technical and detailed work.
    During the pandemic, Boeing and its suppliers shed thousands of workers. They’ve since struggled to hire and train workers in time for the resurgence in air travel and aircraft demand.
    “You’re in an environment where skilled, technical labor is hard to get right now, particularly in aerospace and defense,” said Bank of America’s Epstein. “So what do you do to not only retain them but attract them? If they really want a pension, maybe that gives you a competitive advantage over people who are trying to attract talent.”

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    Fed Governor Waller says inflation softening faster than he expected put him in half-point-cut camp

    Fed Reserve Governor Christopher Waller told CNBC that he supported a 50 basis point rate reduction at this week’s meeting because inflation is easing faster than he had expected.
    Waller indicated there are a number of scenarios that could unfold relative to future cuts, with each depending on how the economic data runs.

    Federal Reserve Governor Christopher Waller said Friday he supported a half percentage point rate cut at this week’s meeting because inflation is falling even faster than he had expected.
    Citing recent data on consumer and producer prices, Waller told CNBC that the data is showing core inflation, excluding food and energy, in the Fed’s preferred measure is running below 1.8% over the past four months. The Fed targets annual inflation at 2%.

    “That is what put me back a bit to say, wow, inflation is softening much faster than I thought it was going to, and that is what put me over the edge to say, look, I think 50 [basis points] is the right thing to do,” Waller said during an interview with CNBC’s Steve Liesman.
    Both the consumer and producer price indexes showed increases of 0.2% for the month. On a 12-month basis, the CPI ran at a 2.5% rate.
    However, Waller said the more recent data has shown an even stronger trend lower, thus giving the Fed space to ease more as it shifts its focus to supporting the softening labor market.
    A week before the Fed meeting, markets were overwhelmingly pricing in a 25 basis point cut. A basis point equals 0.01%.
    “The point is, we do have room to move, and that is what the committee is signaling,” he said.

    The Fed’s action to cut by half a percentage point, or 50 basis points, brought its key borrowing rate down to a range between 4.75%-5%. Along with the decision, individual officials signaled the likelihood of another half point in cuts this year, followed by a full percentage point of reductions in 2025.
    Fed Governor Michelle Bowman was the only Federal Open Market Committee member to vote against the reduction, instead preferring a smaller quarter percentage point cut. She released a statement Friday explaining her opposition, which marked the first “no” vote by a governor since 2005.
    “Although it is important to recognize that there has been meaningful progress on lowering inflation, while core inflation remains around or above 2.5 percent, I see the risk that the Committee’s larger policy action could be interpreted as a premature declaration of victory on our price stability mandate,” Bowman said.
    As for the future path of rates, Waller indicated there are a number of scenarios that could unfold, with each depending on how the economic data runs.
    Futures market pricing shifter after Waller spoke, with traders now pricing in about a 50-50 chance of another half percentage point reduction at the Nov. 6-7 meeting, according to the CME Group’s FedWatch.
    “I was a big advocate of large rate hikes when inflation was moving much, much faster than any of us expected,” he said. “I would feel the same way on the downside to protect our credibility of maintaining a 2% inflation target. If the data starts coming in soft and continues to come in soft, I would be much more willing to be aggressive on rate cuts to get inflation closer to our target.”
    The Fed gets another look at inflation data next week when the Commerce Department releases the August report on the personal consumption expenditures price index, the central bank’s preferred measure. Chair Jerome Powell said Wednesday that the Fed’s economists expect the measure to show inflation running at a 2.2% annual pace. A year ago, it had been at 3.3%. More

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    Boeing’s defense unit chief Colbert is departing, CEO says

    Boeing’s new CEO Kelly Ortberg said the company’s defense unit chief Ted Colbert is leaving Boeing and that a replacement would be named later.
    The defense unit accounted for about 40% of Boeing’s revenue in the first half of the year.

    Former CEO for Boeing’s defense, space and security subdivision Ted Colbert speaks during a press conference in Dubai on Nov. 16, 2019.
    Karim Sahib | AFP | Getty Images

    The head of Boeing’s defense unit Ted Colbert is leaving the company effective immediately, said CEO Kelly Ortberg, marking his first major executive change since he took the top job in early August.
    “At this critical juncture, our priority is to restore the trust of our customers and meet the high standards they expect of us to enable their critical missions around the world,” Ortberg said in a staff memo on Friday. “Working together we can and will improve our performance and ensure we deliver on our commitments.”  

    Ortberg thanked Colbert for his 15 years of service at Boeing and said the unit’s Chief Operating Officer Steve Parker would take over until the company names Colbert’s replacement.
    Boeing’s defense, space and security unit generated nearly 40% of Boeing’s revenue in the first half of this year, but it has struggled with production problems and cost overruns, including on the new 747s that will serve as Air Force One aircraft. In the space sector, Boeing’s Starliner is returning without the NASA astronauts who took it to the International Space Station in June. They will instead take SpaceX’s Crew-9 vehicle back, NASA said last month.
    Colbert did not immediately respond to CNBC’s request for comment.

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    FTC sues drug middlemen for allegedly inflating insulin prices

    The Federal Trade Commission on Friday sued three large U.S. health companies that negotiate insulin prices, arguing the drug middlemen boost their profits while “artificially” inflating costs for patients. 
    The suit targets the three biggest so-called pharmacy benefit managers, UnitedHealth Group’s Optum Rx, CVS Health’s Caremark and Cigna’s Express Scripts, and their affiliated group purchasing organizations.
    The FTC may also recommend suing insulin manufacturers Eli Lilly, Sanofi and Novo Nordisk in the future.

    Lina Khan, Chair of the Federal Trade Commission (FTC), testifies before the House Appropriations Subcommittee at the Rayburn House Office Building on May 15, 2024 in Washington, DC. 
    Kevin Dietsch | Getty Images News | Getty Images

    The Federal Trade Commission on Friday sued three large U.S. health companies that negotiate insulin prices, arguing the drug middlemen use practices that boost their profits while “artificially” inflating costs for patients. 
    The suit targets the three biggest so-called pharmacy benefit managers, UnitedHealth Group’s Optum Rx, CVS Health’s Caremark and Cigna’s Express Scripts. All are owned by or connected to health insurers and collectively administer about 80% of the nation’s prescriptions, according to the FTC. 

    The FTC’s lawsuit also includes each PBM’s affiliated group purchasing organization, which brokers drug purchases for hospitals and other health-care providers. The agency said it could recommend suing drugmakers Eli Lilly, Sanofi and Novo Nordisk in the future as well over their role in driving up list prices for their insulin products.
    A UnitedHealth spokesperson said the suit “demonstrates a profound misunderstanding of how drug pricing works, noting that Optum RX has “aggressively and successfully” negotiated with drug manufacturers.
    A CVS spokesperson said Caremark is “proud of the work” it has done to make insulin more affordable for Americans, adding that “to suggest anything else, as the FTC did today, is simply wrong.”
    And, a spokesperson for Express Scripts said the suit “continues a troubling pattern from the FTC of unsubstantiated and ideologically-driven attacks” on PBMs. It comes three days after Express Scripts sued the FTC, demanding that the agency retract its allegedly “defamatory” July report that claimed that the PBM industry is hiking drug prices.
    PBMs sit at the center of the drug supply chain in the U.S. They negotiate rebates with drug manufacturers on behalf of insurers, large employers and federal health plans. They also create lists of medications, or formularies, that are covered by insurance and reimburse pharmacies for prescriptions. The FTC has been investigating PBMs since 2022. 

    The agency’s suit argues that the three PBMs have created a “perverse” drug rebate system that prioritizes high rebates from drugmakers, which leads to “artificially inflated insulin list prices.” It also alleges that PBMs favor those high-list-price insulins even when more affordable insulins with lower list prices become available. 
    The FTC is filing its complaint through its so-called administrative process, which initiates a proceeding before an administrative judge who would hear the case.
    “Millions of Americans with diabetes need insulin to survive, yet for many of these vulnerable patients, their insulin drug costs have skyrocketed over the past decade thanks in part to powerful PBMs and their greed,” Rahul Rao, deputy director of the FTC’s Bureau of Competition, said in a statement. 
    “The FTC’s administrative action seeks to put an end to the Big Three PBMs’ exploitative conduct and marks an important step in fixing a broken system—a fix that could ripple beyond the insulin market and restore healthy competition to drive down drug prices for consumers,” Rao continued. 
    Roughly 8 million Americans with diabetes rely on insulin to survive, and many have been forced to ration the treatment due to high prices, according to the FTC.
    President Joe Biden’s signature Inflation Reduction Act has capped insulin prices for Medicare beneficiaries at $35 per month. That policy currently does not extend to patients with private insurance.
    The Biden administration and Congress have ramped up pressure on PBMs, seeking to increase transparency into their operations as many Americans struggle to afford prescription drugs. On average, Americans pay two to three times more than patients in other developed nations for prescription drugs, according to a fact sheet from the White House.

    More CNBC health coverage

    The FTC said it remains “deeply troubled” by the role insulin manufacturers play in higher list prices, arguing that they inflate prices in response to PBMs’ demands for higher rebates. Eli Lilly, Sanofi and Novo Nordisk control roughly 90% of the U.S. insulin market.
    For example, Eli Lilly’s Humalog insulin had a list price of $274 in 2017, a more than 1,200% increase from its $21 list price in 1999, according to the FTC.
    The FTC said all drugmakers should “be on notice that their participation in the type of conduct challenged here raises serious concerns.”
    An Eli Lilly spokesperson said the FTC’s suit concerns “aspects of the U.S. health care system that we have long been advocating to reform.” They added that the company last year became the first to cap out-of-pocket costs for all of its insulins at $35 per month for people with private insurance. Eli Lilly also cut some insulin list prices by up to 70%.
    Sanofi last year announced a similar $35 monthly price cap for its most commonly prescribed insulin. Novo Nordisk last year also said it would slash the list prices of some of its popular insulins by up to 75%.
    A spokesperson for Sanofi said the company has not seen and will not comment on the FTC’s complaint against PBMs. But the French drugmaker agrees with the FTC’s claim that PBMs have “leveraged their position as powerful industry middlemen and have exploited rebates…to benefit themselves while increasing costs for patients and payers at the same time.”
    A Novo Nordisk spokesperson said the company is “committed to ensuring patients have affordable access to their medicines, including insulin.” Novo Nordisk does not control the prices patients pay at the pharmacy in the “complex U.S. healthcare system,” the spokesperson noted, pointing to the company’s insulin savings card programs.
    Correction: This story has been updated to correct a quote from the FTC.

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    401(k) savers can access one of the ‘rare guarantees’ in investing, CFP says

    A 401(k) match is often considered free money.
    Most employers offering a 401(k) plan make a matching contribution on workers’ savings.
    Workers may need to stay at the company for a certain number of years before the match is fully theirs, however.

    Nitat Termmee | Moment | Getty Images

    There are few certainties when it comes to investing.
    The stock market can seem to gyrate with little rhyme or reason, guided up or down by unpredictable news cycles and fickle investor sentiment. Average stock returns have historically trended up over long time periods, but their trajectory is hardly assured on a daily, monthly or annual basis. As the common investment disclosure goes, “Past performance is no guarantee of future results.”

    Yet, according to financial advisors, there is an outlier in the realm of investing: the 401(k) match.
    The basic concept of a 401(k) match is that an employer will make a matching contribution on workers’ retirement savings, up to a cap. Advisors often refer to a match as free money.

    For example, if a worker contributes 3% or more of their annual salary to a 401(k) plan, the employer might add another 3% to the worker’s account.
    In this example — a dollar-for-dollar match up to 3% — the investor would be doubling their money, the equivalent of a 100% profit.
    A match is “one of the rare guarantees on an investment that we have,” said Kamila Elliott, a certified financial planner and co-founder of Collective Wealth Partners, based in Atlanta.

    “If you were in Vegas and every time you put $1 in [the slot machine] you got $2 out, you’d probably be sitting at that slot machine for a mighty long time,” said Elliott, a member of CNBC’s Advisor Council.
    However, that money can come with certain requirements like a minimum worker tenure, more formally known as a “vesting” schedule.

    Most 401(k) plans have a match

    About 80% of 401(k) plans offer a matching contribution, according to a 2023 survey by the Plan Sponsor Council of America.
    Employers can use a variety of formulas that determine what their respective workers will receive.

    The most common formula is a 50-cent match for every dollar a worker contributes, up to 6%, according to the PSCA. In other words, a worker who saves 6% of their pay would get another 3% in the form of a company match, for a total of 9% in their 401(k).
    “Where else can you get a guaranteed return of more than 50% on an investment? Nowhere,” according to Vanguard, a 401(k) administrator and money manager.
    More from Personal Finance:The ‘billion-dollar blind spot’ of 401(k)-to-IRA rolloversPlanning delayed retirement may not prevent poor savingsHow high earners can funnel money to a Roth IRA
    Consider this example of the value of an employer match, from financial firm Empower: Let’s say there are two workers, each with a $65,000 annual salary and eligible for a dollar-for-dollar employer 401(k) match up to 5% of pay.
    One contributes 2% to their 401(k), qualifying them for a partial match, while the other saves 5% and gets the full match. The former worker would have saved roughly $433,000 after 40 years. The latter would have a nest egg of about $1.1 million. (This example assumes a 6% average annual investment return.)
    Financial advisors generally recommend people who have access to a 401(k) aim to save at least 15% of their annual salary, factoring in both worker and company contributions.

    Keeping the match isn’t guaranteed, however

    That so-called free money may come with some strings attached, however.
    For example, so-called “vesting” requirements may mean workers have to stay at a company for a few years before the money is fully theirs.

    About 60% of companies require tenure of anywhere from two to six years before they can leave the company with their full match intact, according to the PSCA. Workers who leave before that time period may forfeit some or all their match.
    The remainder have “immediate” vesting, meaning there is no such limitation. The money is theirs right away. More

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    Pesky medical bill? Many people don’t take a key step to manage that debt, study finds

    Many people don’t dispute potential errors on their medical bills because they feel it’s ineffective.
    However, calling a health provider to address a financial concern can, for example, help correct, reduce or eliminate one’s bill, according to a University of Southern California study.
    Doing nothing and avoiding payment may result in late fees and interest, debt collection, lawsuits, garnishments, and lower credit scores.

    Getty Images

    Consumers may feel their medical bills are unyielding, inflexible, set in stone. But that’s not always true: A new study shows patients can often reap financial benefits by disputing charges that seem erroneous or by negotiating for financial relief.
    Of consumers who don’t reach out to question a medical bill, 86% said it’s because they didn’t think it would make a difference — but “the experiences of those who did reach out provide evidence to the contrary,” according to a new University of Southern California study.

    About 26% of people who called because they disagreed with a charge or couldn’t afford to pay it got their medical bill corrected after the outreach, according to the study, published in August. Roughly 15% got a price reduction, 8% got financial assistance and 7% saw their bills canceled outright.

    “Of the people who did reach out, most of them got some recourse through self-advocacy,” said report co-author Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics.
    Researchers polled 1,135 U.S. adults from Aug. 14 to Oct. 14, 2023.
    About 1 out of 5 respondents reported receiving a medical bill with which they disagreed or could not afford within the prior 12 months. About 62% of them contacted the billing office to address the concern.
    More from Personal Finance:When to refinance your loan as interest rates fallWhy working longer isn’t a good retirement planStocks often drop in September — but many shouldn’t care

    “If you can’t afford to pay something, or [if a bill] doesn’t seem right or match what your care experience was, you should call and ask questions about that,” Duffy said.
    Savings can extend into the hundreds or even thousands of dollars, depending on factors like a patient’s health insurance and the type of medical visit or procedure, said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida.

    Bills ‘go all over the place’

    Viktorcvetkovic | Getty

    A 2023 Consumer Financial Protection Bureau analysis of medical bills for adults age 65 and older found that patients “face a complex billing system with a high likelihood of errors and inaccurate bills.” Often, inaccurate bills result from erroneous insurance claims and occur more frequently among consumers with multiple sources of insurance, the CFPB said.
    Common errors included missing or invalid claim data, authorization and precertification issues, missing medical documentation, incorrect billing codes, and untimely filing of claims, the report found. Such mistakes contributed to the “rejection of claims that would otherwise be paid,” it said.
    “[Bills] go all over the place,” said McClanahan, founder of Life Planning Partners and a member of CNBC’s Advisor Council. “And there’s no transparency or rhyme or reason for how [providers] decide to charge.”

    Doing nothing and avoiding payment of medical bills is likely not a good course of action: It could have negative financial consequences, such as late fees and interest, debt collection, lawsuits, garnishments, and lower credit scores, according to a separate CFPB resource.
    “If something seems egregious, question it,” McClanahan said.

    How to manage medical bills

    Consumers should ask upfront what a medical visit or procedure will cost, or inquire what the estimated cost will be, she said.
    Sometimes, consumers will pay “a heck of a lot less” if they pay in cash rather than via insurance, McClanahan said. However, cutting a check could have other consequences like the sum not counting toward one’s annual deductible, she added.
    If you feel you were overcharged, request an itemized bill from the provider or hospital, and look for errors or duplicate charges, according to PatientRightsAdvocate.org. Research the fair market price for a service and use that information to negotiate, the nonprofit group said.

    If something seems egregious, question it.

    Carolyn McClanahan
    physician and certified financial planner based in Jacksonville, Florida

    The phone number for your medical provider’s accounting or billing office will be on your billing statement, the CFPB said.
    Here are three other questions to consider asking about your itemized bill, according to the regulator:

    Do charges reflect the services you received?
    If you have insurance, do the bills reflect the payment by your insurance and reflect what the provider understood would be covered?
    Do any of the charges indicate a service was “out-of-network” when it wasn’t?

    When calling a provider about a medical bill, keep a journal about the communication, McClanahan said. Write people’s names and what was discussed, and get a commitment of when you’ll hear back.

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    Family offices are the most bullish they’ve been in years, survey says

    Nearly all family offices, 97%, expect positive returns this year, and nearly half expect double-digit gains, according to Citi Private Bank’s 2024 Global Family Office Survey.
    Nearly half of family offices surveyed say they plan to increase their allocation to direct private equity in the next 12 months, the largest share for any investment category.
    The survey is the latest sign that family offices — the private investment arms of wealthy families — are starting to make more aggressive bets on market and valuation growth.

    Vm | E+ | Getty Images

    A version of this article first appeared in CNBC’s Inside Wealth newsletter with Robert Frank, a weekly guide to the high-net-worth investor and consumer. Sign up to receive future editions, straight to your inbox.
    Family offices are the most bullish they’ve been in years, putting their cash to work in stocks and alternatives as the Fed starts to cut interest rates, according to a new survey.

    Nearly all family offices, 97%, expect positive returns this year, and nearly half expect double-digit gains, according to Citi Private Bank’s 2024 Global Family Office Survey.
    “This is the most optimistic outlook we’ve seen,” said Hannes Hofmann, head of the family office group at Citi Private Bank, which has been conducting the survey for five years. “What we’re clearly seeing is an increase in risk appetite.”

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    The survey is the latest sign that family offices — the private investment arms of wealthy families — are emerging from two years of hoarding cash and bracing for recession to start making more aggressive bets on market and valuation growth.
    They especially like private equity. Nearly half, 47%, of family offices surveyed say they plan to increase their allocation to direct private equity in the next 12 months, the largest share for any investment category. Only 11% plan to reduce their PE holdings. Private equity funds ranked second, with 41% planning to increase their allocation.
    With interest rates heading down, family offices are also regaining their appetite for stocks. More than a third, 39%, of family offices plan to increase their allocation to developed-market equities, mainly the U.S., while only 9% plan to trim their equity exposure. That comes after 43% of family offices increased their exposure to public stocks last year.

    Public equities remain their largest holding by major asset class, with stocks making up 28% of their typical portfolio — up from 22% last year, according to the survey.

    “Family offices are taking money out of cash, and they’ve put money into public equities, private equity, direct investments and also fixed income,” Hofmann said. “But primarily it’s going into risk-on investing. That is a very significant development.”
    Fixed income has become another favorite of family offices, as rates start to decline. Half of family offices surveyed added to their fixed-income exposure last year — the largest of any category — and a third plan to add even more to their fixed-income holdings this year.
    With the S&P 500 up nearly 20% so far this year, family offices are looking for 2024 to end with strong returns. Nearly half, 43%, expect returns of more than 10% this year. More than 1 in 10 large family offices — those with over $500 million in assets — are banking on returns of more than 15% this year.
    There are risks to their optimism, of course. When asked about their near-term worries about the economy and financial markets, more than half cited the path of interest rates. Relations between the U.S. and China ranked as their second-biggest worry, and market overvaluation ranked third. The survey marked the first time since 2021 that inflation wasn’t the top worry for the family offices surveyed, according to Citi.
    One of the big differences that sets family offices apart from other individual investors is their appetite for alternatives. Private equity, venture capital, real estate and hedge funds now account for 40% of the portfolios of the family offices surveyed. That number is likely to keep growing, especially as more family offices make direct investments in private companies.
    “It’s a significant allocation that shows family offices are asset allocators who are long-term investors, highly sophisticated and taking a long-term view,” Hofmann said.
    One of the biggest themes for their private investments is artificial intelligence. The family offices of Jeff Bezos and Bernard Arnault have both made investments in AI startups, and repeated surveys show AI is the No. 1 investment theme for family offices this year. More than half of family offices surveyed by Citi have exposure to AI in their portfolios through public equities, private equity funds or direct private equity. Another 26% of family offices are considering adding to their AI investments.
    Hoffman said AI has already proven to be different from previous investment innovations such as crypto, and environmental, social and governance, or ESG. Only 17% of family offices are invested in digital assets, while a vast majority say they’re not interested.
    “AI is a theme that people are interested in and they’re putting real money into it,” Hofmann said. “With crypto people were interested in it, but at best, they put some play money into it. With ESG, we’re finding a lot of people are saying they’re interested in it, but a much smaller percentage of family offices are actually really putting money into it.” More