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

BCBS of TX has asked for rate hikes of nearly 60% for 3 popular ACA HMO plans in that state. In OK, BCBS is seeking rate increases averaging 49.2% for ACA plans. HCSC (BCBS IL, TX, NM, MT, OK parent) has seen a 107.4% jump in its average claims per member per month for ACA plans. In 2017, Blue Cross on MN is canceling ACA plans for 103,000 people and leaving in place only its narrow HMO plans where only 13,000 are enrolled.

United Healthcare currently competes in 34 state ACA exchanges, but has announced withdrawals from 31 of those states due to losses.

BCBS of NC and Highmark in PA are suing the federal government for their ACA risk corridor payments. Also suing is struggling Illinois co-op Land of Lincoln, which says it was shorted $72.8 million. The co-op is dropping out of the group market in 2017. The payments were supposed to be funded by profitable plans, but only 12.6% was funded through other carrier payments and Congress has refused to appropriate the extra money, since funding by the government for the risk corridor payments was not built into the law.

Financial website The Motley Fool says that nearly 21% of U.S. healthcare expenses, or approximately $190 billion of expenses are caused by obesity.

The average cost for health insurance benefits in the private sector was $2.44 per hour in March 2016. That is 7.6% of total average compensation. Interestingly, costs increased by size of company with the highest cost being $4.27 per hour (9.1% of compensation) for groups of 500 employees or more as reported to the U.S. Bureau of Labor Statistics.

SHRM reports that from 2015 to 2016, 3 out of 5 organizations reported their benefit offerings remained the same for all benefits offered to employees. Only 7% of organizations say they decreased benefit offerings.

PwC’s Health Research Institute is projecting a 6.5% increase in medical cost trend in 2017. This is the same as their prediction was for 2016.

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Out of pocket spending on inpatient hospitalizations increased 37.3% in the years following ACA according to a study published by JAMA Internal Medicine that was conducted by the University of Michigan.  Patient deductibles increased by 86% and coinsurance grew by 33%, while copayments were reduced by 26.7%.

In a paper published in the Journal of Health Economics, researchers found that 86% of participants in health plans could not define four terms on a multiple choice questionnaire. The terms were deductible, copay, coinsurance and out of pocket maximum.

Have a safe Independence Day!