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S&S Benefits.....Opinion,
Hearsay & News Review S&S Benefits Consulting, Inc.
219
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Milliman/ |
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Catastrophic Claims
Increase Dramatically |
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Claims in Excess
of $1,000,000 per Million Lives Year |
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Year |
Claims
Per Million Lives |
Average
Claim |
Claim
Cost Per Life |
2000 |
5.3 |
$1,284,647 |
$6.81 |
2001 |
4.9 |
$1,442,423 |
$7.07 |
2002 |
4.9 |
$1,558,345 |
$7.64 |
2003 |
20.4 |
$1,202,054 |
$24.52 |
2004 |
28.3 |
$1,180,732 |
$33.41 |
2005 |
37.9 |
$1,169,833 |
$44.29 |
2006 |
38.3 |
$1,473,922 |
$56.45 |
Independence Holding Company that owns Standard Security Life, Madison National and American Independence Corp. and has considerable stop-loss business, echoes what we have been hearing from many markets. Profitability is down for them and many other carriers (after 61 consecutive quarters of positive net income for IHC). The market is soft despite the increasing frequency and severity of claims. In other news, Companion Life has purchased MGU Montgomery Management Corp.
A Cook County, Illinois judge has just increased the cost
of healthcare in
The
Mercer reports total health benefit costs rose 6.1% in 2007 to an average of $7,983PEPY. CDHP cost was $5,970. HMO-$7,120. PPO-$7,352.
Cigna has purchased Great-West Health for $1.5Billion in
cash plus $400M it will invest in the business. For 2.2M members, that works out
to be about $864 per member. We find the sale troubling as competition continues
to dwindle in the health insurance market. Cigna also has settled with NY
Attorney General Cuomo by making changes in its physician ranking program in NY.
Condell Medical Center in Libertyville, IL has sued BC/BS of IL for $22.9M for services it says BC has not paid for it’s members plus $3M for breaching it’s obligations under the contract.
Humana has been hired by the UK National Health Service to help them enhance the patient experience, improve clinical outcomes and reduce costs. Ironic that a government run health system needs help from an American insurer.
Advocate in
The Rippe Lifestyle Institute says that more than two-thirds of Americans are overweight or obese. Overweight people have 13.8% higher annual health costs and obese people have 37.7% higher costs. It is estimated that obesity causes 40%-70% of hypertension cases, over 50% of blood lipid problems and over 80% of Type 2 diabetes and almost 100% of metabolic syndrome cases. Over the past decade, obesity has grown by more than 40%. However, it is listed as the cause of only 0.3% of claims submitted by physicians.
A.M. Best has restored Trustmark Insurance’s A- rating.
MedAdvant is selling NPPN (National Preferred Provider Network) to Coalition