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