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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/  January 2007 Issue


The big news in all the publications is about the latest legislation allowing larger contributions to HSA accounts. The news came too late to encourage much in the way of enrollment changes, but it will help those that already have HSA accounts. Employees can now contribute up to $2850 for single and $5,650 for families, even if the deductible is less. Also, Express Scripts has offered a bid for Caremark Rx in an effort to break up the takeover deal between Caremark and CVS.

A Watson survey says that 22% of top performers cite health benefits as a top three reason to leave a company. In a survey of 12,000 workers, 69% are concerned that their employer will increase out of pocket costs and 43% are concerned their company will reduce pension or 401(k) benefits. Another Watson survey says the use of Health Risk Assessments is projected to rise 21% in 2007.

Meritain Health has announced the  acquisition of CBSA PERFORMAX, which is a combination of another merger that took place in August 2006. Meritain had acquired Weyco, Inc. (of the Howard Weyco non-smoking fame) in 2006 also. The TPA industry continues to consolidate, perhaps in reaction to a continuing flood of federal regulations which threaten to drive competition from the health insurance business.

A Spencer survey says that the average claim costs for COBRA continuees exceeded costs for active employees by about 45% for 122 companies surveyed in 2006, but varied radically between employers. The survey of those companies said that 10.1% of employees and dependents became eligible for COBRA and 26.6% of those eligible took the coverage.

A Kaiser survey found that 57% of CDHP enrollees make medical decisions differently due to cost considerations. The KFF survey also said that 23% of CDHP enrollees felt they needed medical care, but didnít get it due to costs, verses 11% of  traditional plan enrollees making the same decision. Half of CDHP users would switch plans if given the opportunity, compared to 33% in traditional plans. When compared to a control group: 45% had incomes of $75K or more compared to 30% in the control group; 64% of CDHP users reported excellent health compared to 52% in the control group; and 23% reported a chronic health condition compared to 35% in the control group.

One of Aetna ís vendors, Concentra Preferred Systems, along with 5 other tenants in the same building, was robbed. Among the information taken was back-up tape cassettes containing PHI of less than 1% of Aetna plan members.

For the 4th consecutive year, 51% of surveyed CEOs of the Business Roundtable say that health care costs are the greatest financial burden facing their business. The next most cited concern was energy prices.

An AllianceBernstein says that 61% of investors arenít confident managing their investments and donít enjoy it. Nearly half of those surveyed view their investments no more than once a year and 32% donít view them at all. Do employees really want more control of their 401(k) plans?

More than 70% of U.S. consumers in a HealthMarkets survey say they know little or nothing of how their doctors charge compared to other doctors. When asked to predict the cost of procedures, most predicted well below the costs charged, yet 13% of those surveyed said the high cost of health care had caused them to fall behind on other bills.

A Harris/WSJ survey of 3,561 adults revealed that nine in ten were content with the health coverage they had and that less than  6% expected to switch and less than 0.5% expected to drop their plans in 2007.

The Federal courts have held that ERISA pre-empts the pay or play health care statute in Maryland that had applied to nongovernmental employers of more than 10,000 persons in the state. Perhaps this will end the disturbing trend of state by state mandates on the issue.

The DOL, HHS and IRS have published final guidance on rules for implementing wellness programs while complying with HIPAA nondiscrimination provisions. The guidance clarifies that employers may reward workers up to 20% of employee only coverage costs for meeting health-related goals in wellness programs and generally must have available a reasonable alternative standard. The guidance is effective for plans beginning on or after July 1, 2007 and can be viewed at www.dol.gov/ebsa

A survey by America ís Health Insurance Plans (AHIP) of more than 650,000 small groups showed that 57% of employees chose PPO plans, 39%  chose HMO and 4% chose a CDHP.

The fall trend survey of Aon showed trend at 11.4% for HMO, 11.2% for POS, 11.6% for PPO and 10.5% for CDHP.

HAPPY NEW YEAR!