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

HHS has issued 2017 out of pocket limits for medical plans. In 2017, the limits will be $7,150 for single coverage and $14,300 for family coverage.

Health Care Service Corporation (BCBS parent in 5 states including Illinois and Texas), shrank its net loss in 2015 to $65.9 million from $281.9 million the year before. The losses were largely due to exchange plans. Highmark Blue Cross announced a loss of $590 million on ACA plans in 2015. They claim they are owed $500 million from the government’s failed risk corridor program.

A report by IMS Health showed that specialty RX spending increased 26.5% in 2014 to $124.1 billion.

The number of plans offering an HRA or HSA decreased by 29% in 2015, to 23.9% of plans. Enrollment in HRA plans remained flat for the last three years.

IBD reports that of the 11.7 million who signed up for Obamacare last year, only 8.8 million remained enrolled at year end. Expect the same thing to happen to the 12 million who signed up for 2016.

The CBO reports that Obamacare may have reduced the number of people with health insurance. In 2013, the CBO projected that without Obamacare there would be 160 million people with employer based plans and 26 million with individual plans. The CBO now says that in 2016, there are 155 million with employer coverage, 12 million with Obamacare exchange plans and 9 million with other individually purchased plans. That means approximately 10 million people have lost coverage. It appears there is nothing like a government mandate to make things worse.

Segal surveyed 200 clients and found that of those with stop loss coverage, 87% had only individual coverage, while the other 13% had aggregate coverage. Another interesting finding was that 20% of the employers purchased specific coverage of $500,000 or more, up 6% from the year before.

Anthem is suing its PBM vendor (Express Scripts) to recover damage for pharmacy pricing that was higher than competitive benchmark pricing. However, they have not terminated their contract with Express Scripts.

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KFF found that in 2014, only 55% of employers offered coverage to employees, down from 66% in 1999. Also, of those offered benefits, 62% took the offer, down from 66% in 1999.

From 2014 to 2015, health spending grew by 4.7%, versus only 2.1% for non-health GDP. Growth in health services spending accounted for over 1/5^th of GDP growth.

The number of companies self-insuring is up according to the Kaiser-HRET survey. The number of employers who fully and partially self-insure has increased from 44% in 1999 to 63% in 2015. In 1999, 13% of employers with 3-199 employees self-funded and now that number has increased to 17% in 2015.

Fortune magazine reports that 34% of companies paid 100% of the cost of employee health care in 2001, but now only 9% of employers are that generous. The current average contribution for employees is now 18% of premium for single coverage and 29% of premium for family coverage.