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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/   December 2011 Issue


The abbreviated summaries of benefits required to be distributed under PPACA were originally scheduled to be distributed 3/23/2012. However, due to confusion between the DOL, IRS and HHS there is a lack of final regulation and the notices won't be required until final regulations are issued and a sufficient time schedule is established. The confusion (should we be surprised?) extends to the fact that no one knows when final regulations are expected.

In November, HHS announced that it will immediately begin a pilot audit program to assess compliance with HIPAA Privacy and Security Rules and Breach Notification Procedures. The audit program will be run through HHS's Office of Civil Rights (OCR). The pilot program will initially assess 150 selected entities. The remainder of audits will begin in May 2012 in the continuing waste of tax dollars for idiotic federal programs designed to protect information that was never intentionally used by the entities to violate someone's privacy.

The seven largest publicly traded health insurers saw net income increase by7.8% from 2010 to 2011.That figure includes decreases in net income for Wellpoint and Health Net. Both Aetna and Coventry saw enrollment decreases and Aetna and Health Net saw overall revenue decreases. Other insurers included Cigna, Humana and UnitedHealth Group.

In a "bold" move, HHS's first review of an insurer's planned rate changes resulted in the condemnation of a planned 12% rate increase for tiny Everence Insurance of Pennsylvania. Although HHS does not have the ability to rule on rate hikes, they do have the ability to review and apparently to publically condemn anything that the HHS "experts" see as being excessive. Kudos to HHS for choosing to pick on the smallest possible entity, taking time away from publishing any final regulations on the abbreviated benefit summaries they also want to require. There is a multi-syllable word to describe the incompetence of HHS and Obamacare in general and it begins with the letters "cluster."In the long run, that may be good for the country.

The Council of Insurance Agents and Brokers queried their members about their client's premium increases. Groups with 50 and fewer employees saw the largest increases, with 39% averaging 11% to 20% increases (which is less than the 62% who reported increases in May 2011).  Sixty-nine percent of groups from 51 to 500 employees experienced increases in the 6% to 15% range (down from 75% reporting increases in May). Fourteen percent of large employers with more than 500 employees reported no increase, compared with 5% reporting no increase in May.

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The Mercer survey of 2,844 employers was released in mid-November. According to that survey, average costs per employee year rose 6.1% to $10,146. Last year's rise was 6.9%. Thirty-two percent of large employers have countered rising prices by offering CDHPs, up sharply from 23% last year. The average CDHP cost was $7,787 in 2011 compared to $9,385 for PPO coverage. Costs per employee are highest in the Northeast ($11,334) and West ($11,115) compared to the Midwest ($10,360) and the South ($9,442). Forty-seven percent of employers plan to raise deductibles or premium contributions for employees in 2012. For large (+500 ees) employers costs increased 3.6% this year while for small employers costs went up by 9.9%. As far as Obamacare goes, 14% of small employers said it was likely they would terminate coverage in 2014, compared to 9% of employers with at least 500 employees and 4% of employers with 5,000 or more employees.