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