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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/   July 2012 Issue


As this is written, it is the day the Supreme Court of The United States has upheld Obamacare, the largest tax increase in the history of the country. It is notable that apparently all behavior (activity or inactivity) can be taxed. Even if a new Congress and President are elected and repeal the law, look forward to more taxes, since the courts almost always use precedent in making their decisions.


A Towers Perrin survey of large companies showed that 70% of large companies will offer high deductible plans by 2013 and that 20% now offer those plans as their only option.


 A report by PwC says that health care costs are expected to grow by 7.5% in the  U.S. in 2013. A survey of 1,400 employers shows that 57% are increasing employee contributions to medical plans, 50% are considering increasing deductibles for medical plans and 52% are increasing prescription cost sharing.


Aetna is saying it will rebate 0.5% of premiums collected under the MLR portion of Obamacare. The company has 200 rebate pools nationwide and met MLR requirements in all but 28% of them.


Wellpoint is  buying 1-800-Contacts to expand its direct to consumer offering. The eyewear company has 3.3 million customers.


Even without Obamacare, California was moving to force insurance companies to cover individuals with medical conditions and limiting their ability to set rates accordingly. Kaiser Health reports that sponsoring senators wanted to lead the way in the country. Apparently, being second to Illinois in terms of states in the worst financial condition, wasn't good enough.


Many articles were published in advance of the Obamacare decision as to which provisions major insurance companies would keep in their policies if the law was dumped by SCOTUS. Most articles were breathless that many provisions of the law were good and the companies would retain many parts of the changes that have already been made. What the articles did not say is that even if a future Congress repeals the law, most of the provisions would still stay, since it cost the insurance companies billions of dollars to change their claim systems the first time.


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Blue Shield of CA is being sued by Consumer Watchdog for engaging in "death spiral" tactics by pushing older and more sick members into low benefit, high deductible plans. There is a 1993 CA law against such tactics. Blue Cross of Massachusetts is offering a new plan that charges a higher deductible for using more expensive hospitals.

According to the AMA, the seven largest insurance companies process one in 10 medical claims incorrectly in 2012, compared to 2 in 10 in 2011. UHC was rated the best at 98% while Humana was the worst at 87%. One wonders if the insurance companies are surveying doctors to see how many submit claims correctly.

The new Obamacare FSA limit of $2,500 for medical expenses goes into effect on January 1, 2013. Those with plan years on other than January 1st, don't have to make the change or worry about tax consequences until a new plan year begins after January 1st.

The Health Care Cost Institute's Health Care Cost and Utilization Report has been released. The average price for an inpatient admission increased 5.1% from 2009 to 2010, rising to $14,662. A surgical admission increased in average cost from $25,000 to $27,000. Outpatient services saw the largest jump in price at 10.1%. Primary care office visits  averaged $86 in 2010, up from $82 in 2009. The average brand name drug cost per script rose from $201 to $228, while generic drug script costs reduced from $38 to $35.

AT THE CLOSE OF THE CONSTITUTIONAL CONVENTION, a woman asked Benjamin Franklin what type of government the Constitution was bringing into existence. Franklin replied, A republic, if you can keep it.

Looks like we are losing it.                                  

Have a Great and Safe Independence Day!