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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 click: mailto:jseiler@ssbenefits.net                                              http://www.ssbenefits.net/ February 2006 Issue

Aetna has announced that CEO and Chairman John Rowe is retiring at the end of 2006 and that President Ronald Williams has been named President and CEO. Williams has been with Aetna since 2001 and has helped lead Aetna to profitability.

ULR has settled with Attorney General Elliot Spitzer. The former president and CEO of ULR (Doug Cox) has settled for $2million in restitution to policyholders. The company is now defunct. Spitzer had alleged that as much as two-thirds of ULR’s income came via secret insurance company payments. Cox has since started another company. Just wondering who will trust that venture?

According to the Centers for Medicare/Medicaid Services (CMS), health care spending rose 7.9% in 2004, down from 8.2% in 2003 and 9.1% in 2002. Spending on Rx grew 8.2% in 2004, down from 10.2% in 2003 and 14.3% in 2002. CMS says that Americans spent an average of $6,280 per person on medical care in 2004 and that health care spending accounted for 16% of the GNP.

A Heritage Foundation study says that self-funded plans save $26.72 PEPM ($321 per employee/year) from ERISA’s Exemption from state mandated benefits. Plans were analyzed in 37 states and each state averaged 26 mandated benefits. Mandated benefits require that insured plans cover certain benefits or that insurers offer coverage for specific types of health care providers.

A study by the Employment Policies Institute reveals that employer funded health care mandates such as the recently passed “Wal-Mart Bill” in Maryland , have little effect on the uninsured. The reason is that the vast majority of those who experience loss of coverage are unemployed, employed part-time, employed at firms with fewer than 10 employees or newly employed and have yet to qualify for insurance under eligibility rules. In a surprising moment of clarity, BenefitNews.com said that Jason Judd, a campaign director for the AFL-CIO, didn’t take issue with EPI’s findings. We didn’t bother to look and see if he was still employed by the union.

Assurant has been barred by a federal court from selling its cancer and accident insurance products, due to copyright infringement laws relating to AFLAC’s products. Assurant executives plan to appeal the decision. Apparently AFLAC executives are saying that “If it walks like a duck……”

The NAIC reports that complaints against insurance carriers about delays and denials of payment accounted for more than 40% of the nearly 200,000 complaints filed last year with state insurance departments. That number is down 22.4% from 2004. Auto complaints top the list at 41% of complaints while accident and health complaints came in second with 34%.

Public employers will have to disclose their non-pension retiree benefit liabilities as soon as December 15 of 2006 under a new Government Accounting Standards Board rule, similar to the one required by FASB in the private sector. The rule affects government bodies with $100 million or more in annual revenues. In 2007, it will go down to those with at least $10 million in revenues and in 2008 for those with less than $10 million in revenues. The ruling does not require funding of the liabilities, but may affect bond availability when assessing a public entity’s financial condition.

Cigna was fined $150,000 by the state of New York for repeatedly failing to acknowledge within 15 days, consumer complaints sent by the Insurance Department’s Consumer Services Bureau.

A study from America ’s Health Insurance Plans and PWC says that higher utilization of services accounts for 43% of premium increases. Medical liability and defensive medicine contribute to 10% of medical cost increases. Of the 8.8% increase in health insurance costs between 2004 and 2005, new treatments, technology, provider consolidation and increased demand accounted for 4.3%.

A Deloitte survey of 152 U.S. employers shows that the cost increases for HSA and HRA plans increased by 2.8% for 2004 to 2005, compared to standard PPO plans at 7.2%. The validity of this study is somewhat suspect since only 22% of employers are said to offer such plans and even less have a significant number of employees enrolled in the plans. The American Health Insurance Plans reports that only 1 million employees were enrolled in such plans in March 2005.

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