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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  2011 Issue

According to the National Association of Dental Plans, dental benefits enrollment dropped by 5.7% in 2009, the first drop in enrollment since 1994.  Researchers found that 166 million Americans (54%) were covered by some form of dental benefit. Sixty-nine percent of commercial dental plans were PPO and 85% of enrollees paid some portion of the premium for their plans.

Access Community Health Network is terminating their contract with Humana for HMO and PPO effective February 1, 2011. Access has over 50 locations in Cook and DuPage Counties in Illinois.

The BLS reports the average cost for insurance benefits for workers in private industry was $2.24 per hour worked as of September 2010, or 8% of total compensation. Insurance costs were highest among union workers at $4.84 per hour as opposed to non-union costs of $1.94 per hour worked.

According to several reports we’ve received, Medicare Part D drug premiums are increasing by 30%. Obamacare, working for you.

However, the Obama administration has also announced that it will require health insurers to disclose and justify any increases of 10% of more in the premiums they charge next year in the individual and small group markets. One may wonder how the administration gained such regulatory authority, especially since it was not in the ACA? Did the states cede their authority? However, the ‘death panels “ were also excluded from ACA, but the NY Times reported Christmas Day that Queen Sebelius is going ahead with regulations that would put such panels into place for Medicare. What the Obama administration can’t achieve legislatively, they seem to be going ahead with through regulation. As a State Senator for Illinois, Obama was interviewed on television and intimated that the Constitution of the United States is a living document. The question now is, can a document remain living after it is shredded?


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Are you grandfathered? Aon Hewitt’s study says that health care cost increases in 2011 will be at their highest level in five years, averaging an 8.8% increase in 2011. Factors driving the increase are higher medical claim costs, an aging population (obviously why the need for the panels), and changes created by “health reform.” (Shhh…Aon Hewitt! Don’t tell Queen Sebelius or she will threaten you.) The same study shows that employer paid premiums for employees has gone from 82% of cost in 2002 to 77% in 2009. For dependents the figure was 77% in 2002, going down to 73% in 2009. PPO deductibles average $522 in 2010 for individuals and $1,206 for family. Out of pocket costs (excluding deductibles) average $2,084 for individuals and $4,428 for families in 2010.

A 2008 law required that mental health/substance abuse benefits, if offered by larger health plans, be covered the same as any other illness. The legislation is just beginning to affect some plans in 2011. The Screen Actors Guild , Plumber’s Welfare Fund, Woodman’s Food Market and others have chosen to drop the coverage rather than shoulder the additional cost burden.

If states such as Texas and Indiana don’t drop Medicaid completely due to the expansion of the programs under Obamacare, insurers such as UHC and Wellpoint are gearing up for expected Medicaid growth under Obamacare. In 2014, the law increases Medicaid enrollment by an estimated 16 million people, which means another $38 Billion in Medicaid revenue for companies to manage the plans (By the way, the $38 Billion is paid with your taxes). Current industry revenue (your taxes) is at about $56.5 Billion. Medicaid will be expanded to accept enrollees with incomes up to 133% of federal poverty level.