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S&S Benefits.....Opinion, Hearsay & News Review

Why be like everyone else?

S&S Benefits Consulting 219 Darien, Dundee, IL 60118 Phone: 847-428-5353, Fax:847-428-9876,

Email: ssbenefits@interaccess.com IF YOU WOULD RATHER RECEIVE THIS VIA E-MAIL !!!!

Volume 2 Issue 8-Street Talk July, 2000 Issue

According to Ceridian Benefits Services, HMO Medical premiums have increased by over 9% since last year with average rates of $191.31 single and $528.73 family. Non HMO rates have increased by over 7% with average rates of $203.67 single and $556.79 family. Dental rates are increasing by over 6% with average rates of $21.46 single and $62.13 family. These rates are US averages.

The founder of U.S. Healthcare has resigned from the Aetna board of directors. The price of Aetna’s stock rose the day Leonard Abramson resigned.

"You win some, you lose some", so the saying goes. In Texas, the first state to allow lawsuits for damages against HMOs, Aetna went to court to fight that law and instead ended up with a ruling that said that the state cannot force HMOs to participate in independent reviews. However, Aetna, Cigna and Pacificare have said they will continue voluntarily to participate in outside reviews, but the end result of the ruling may mean that patients will have to sue to have their case heard in the future. There is no guarantee on how long HMOs will continue to voluntarily participate. In those reviews, HMO decisions were overturned 49% of the time.

Humana has agreed to pay $14.5 million to settle allegations it provided inaccurate information to the federal Medicare program. The settlement ended an investigation of Medicare payments to Humana from 1990 to 1998 for patients who were incorrectly listed as being eligible for both Medicare and Medicaid. Medicare provides higher payment levels.

The annual growth rate of HMOs dropped to just 2.6%. 30 plans went out of business between January and July of 1999. Enrollment dropped for the first time between January and July 1999 by just over one half million members.

The three largest American automakers (GM, Ford and Chrysler) announced that they will extend healthcare benefits to partners of gay employees.

Aetna is dropping its Medicare+Choice plans in eleven states in 2001. The states are Illinois, Georgia, Florida, Indiana, Kentucky, Louisiana, Maine, Ohio, Texas, Connecticut and parts of Pennsylvania, New York and Northern California. Reimbursements from the government are too low to keep operating according to the company.

Foundation Health Systems is also dropping its Medicare+Choice products in 18 counties in six states including Arizona, California, Connecticut, New Jersey, New York and Pennsylvania. Oxford has announced it is dropping its Medicare plans in 8 New Jersey counties.

The US House has passed a bill by a wide margin that would allow doctors to collectively bargain with health plans. Although passage is not as likely in the Senate, the AMA is backing the proposal and the Senate could end up passing a similar bill.

If you are not already on our e-mail distribution list, now may be the time to switch from fax to e-mail. Drop us an e-mail at ssbenefits@interaccess.com to receive this newsletter via e-mail.

We hope to take a break and not publish an August newsletter because issues seem to have cooled for the summer while the weather has heated up. Have a nice summer!