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S&S Benefits.....Opinion, Hearsay & News Review

S&S Benefits Consulting, Inc.  219 Darien , Dundee , IL 60118   Phone: 847-428-5353, Fax:847-428-9876

Email click: mailto:jseiler@ssbenefits.net                                                    http://www.ssbenefits.net/              April 2005 Issue

If your company has multiple plans, do you have “integrated” lifetime limits that apply to all health benefit plans offered? If not, according to a recent article from EBIA, there is the possibility that someone who reaches the lifetime limit under one plan could use HIPAA special enrollment rights to move to another plan your company offers.

Somewhat Unique: BC/BS of NC recently implemented a broad program to combat obesity, since the insurer found that obese patients cost 32% more than others and overweight patients cost 18% more. The insurer found that 50% of obese people didn’t think the condition impacted their health. Coverage was added for 4 physician visits per year for obesity treatment, two weight loss drugs and six dietician visits. Steerage to centers of excellence is provided for those requesting/needing bariatric surgery.

Briefly: Sir Spitzer has announced that AON has agreed to pay $190M back to clients and adopt reforms to end bid rigging. Michael T. McRaith has left his law firm to take the $113,200 a year job as the Director of the Illinois Division of Insurance. Need we say more? The University of Chicago Hospital has terminated with Unicare effective 3/2/05. Long term care sales declined in 2004 according to LIMRA. Part of the reason may be that costs of policies have increased due to lower than expected lapse ratios. This made initial pricing for the product unprofitable. SHRM reports that rising medical costs ranked as the top issue for 57% of 587 business executives surveyed. MetLife reports that most call centers have 30%-40% absenteeism and high turnover. Are you looking forward to great service from an HR outsourcing company on your company’s next open enrollment?

IRS Ruling 2004-55 now gives employers with non-contributory LTD and STD plans the option to structure those plans so employees can receive a tax free benefit by having their coverage cost included in their W-2 income. Clarification would be needed with the insurance carrier so that benefits would be paid correctly.

There has been a lot of noise about the several large employers (such as GE, Bell South, etc.) that have banded together to offer a National Health Access plan to uninsured workers who are ineligible for current employer based coverage. The plan is to offer six levels of benefits. The levels begin at discount card and work their way up to an HSA account. Employers must have more than 5,000 eligible workers and the company must pay $20K to participate. In case you are wondering, there are no bargains here folks.  They are strictly voluntary plans and a sample rate in benefitnews.com for a female with maternity coverage in Chicago with a $1,100 deductible and $5,000 OOP is $394.96 per month. Such a rate is cost prohibitive for most part-time workers.  Go to www.ssbenefits.net to the Useful Links area to see more rates and facts when you click on “National Health Access.”

Want to make your group healthier? The winners of a lottery for 120,000 Taiwanese who had not used the National Health System in the last 5 years included 3 people over the age of 66 who shared their secrets. They were: walking barefoot on the grass, shunning snacks, taking everything step by step without haste, a vegetarian diet, regularly practicing yoga and chanting Buddhist scriptures. Hear the chanting in the company cafeteria?

As of September 2004, the average worker in private industry in the U.S. made $16.96 per hour in wages plus $6.89 in benefits for total compensation of $23.76. Included in benefits was health insurance at $1.56 per hour.

Consumer Reports has put up a web site to help employees choose the best, most cost effective drugs for their condition. We have a link to that website. Go to www.ssbenefits.net and use the “Useful Links” tab to find the “Consumer Reports- Best Buy Drugs” link.

The average 65 year old couple retiring today will need $190,000 to cover medical costs over the next 15-20 years according to Fidelity Investments. That figure is up 8.6% from the previous year. The estimate includes having no retiree health plan, the expenses associated with Medicare Part B and D premiums, cost sharing provisions in the Medicare plan and prescription drug costs. This is in the face of the fact that a recent survey by EBRI shows that only 13% of employers offer retiree coverage to Medicare eligible retirees, down from 20% last year.

A survey of 555 large employers by the National Business Group on health shows that 70% have disease management programs, compared to 49% last year. Fourty-one percent of employers say they will absorb medical cost increases in 2005, up from 29% in 2004. Fourty-nine percent have moved to a single national plan instead of multiple regional plans, up from 29% in 2004.

We’ll be honest, writing this can be fun, but we really want to generate business relationships. If you like this newsletter, you may want to consider using our services to provide good advice on your benefit plan. Perhaps you will want to pass along our name to someone who could use excellent, straight-forward, cost saving advice. Don’t be shy. Call us for help. If you have a friend in need, forward them a copy or send them to our website to subscribe.