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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 : jseiler@ssbenefits.net                                               http://www.ssbenefits.net/   August 2008 Issue


The IRS has ruled that mini-med plans (offering only limited fixed indemnity benefits and specified disease coverage) that provide benefits below the minimum deductibles of HSA plans will make an the HSA ineligible. However, access to an employer on-site clinic providing free or low-cost health care will not make an HSA ineligible so long as the health care is limited to preventive care and other benefits that are not “significant benefits in the nature of medical care.”

A Tillinghast survey on stop loss coverage shows that stop loss premiums increased an average of 14% from January 2006 to January 2007. The previous four surveys had similar increases in the 14%-15% range. These increases are generally low compared to actuarial trend for stop loss, which would be 15%-20% for a $50,000 specific level. Stop loss rates for indemnity plans are generally about 27% higher than stop loss on PPO plans.

HMO cost hikes are expected to go down to 11.9% in 2009 compared to 13.2% in 2008. Hewitt gathered data from 160 large companies with one million participants. They say that after plan changes, negotiations and terminations, the final average increase in 2009 could be 2% lower than the forecast.

Blue Cross of IL has announced that they will no longer print and mail EOBs that relate to patient share zero liability claims (claims that require no additional payment by the member). They say that those claims can still be viewed and downloaded online by members. This is supposed to be an “eco-friendly” approach to claims. However, it will be interesting to see how this affects those who are erroneously billed by providers for amounts that were discounted. Unless members have knowledge of benefits and access to computers, they may end up unnecessarily paying for charges. In mid-December 2008, the Blues will begin to bundle all EOBs into one envelope on a weekly basis. It is also interesting to note that the same company that will not issue supposedly HIPAA protected information on renewal, sends EOBs to employees for covered family members who are over the age of 18.

S&S Benefits Consulting……We Solve Employee Benefit Problems-Give us a call the next time you need help.


The WSJ reports that the growth rate of branded prescriptions began to decline late last year and declined to a projected 1.5% annual growth rate from January to May of this year. This compares to an average growth rate of 3% between 2003 and 2007.

Unicare has announced that it has re-contracted with Rush Systems for Health in Chicago . BCBS-IL has announced it has extended its agreement with Advocate (including the newly Advocate acquired Condell Hospital ) until 2010.

Evanston Hospital and Northwestern University are severing their relationship and a new one is going into place with the University of Chicago .