Benefits.....Opinion, Hearsay & News Review
Highmark Insurance Group reports
that the incidence of medical claims of $1,000,000 or more per individual in a
year has doubled in the five year period from 2008 to 2012. The incidence per
100,000 claims jumped from 2.1 to 4.2 for claims over $1 million. For claims
over $750,000 the incidence went from 5 to 9.8 and for claims over $500,000 the
incidence went from 16.5 per 100,000 claims to 27 per 100,000 claims.
A Towers and NBGH study places
2014 medical costs at $9,560 for employers plus $2,975 for employees. The
employer share is up 27% from 2009, while the employee share has jumped 32%.
This most likely accounts for the drop in satisfaction with health benefits that
was 69% in 2007, but dropped to 59% in 2013. An ADP study shows that 90% of
FTEís are eligible for medical benefits in 2014 and there is 68% participation
of those eligible. The figures are stable since 2010.
A new survey by Buck of 126
insurers and administrators says that health care costs will rise by 8%-9% in
2014 with PPO plan costs rising by
Massachusetts is junking their
exchange and shifting to the federal exchange. Their system has never been able
to enroll people from start to finish. Ironically, this is the state that
Obamacare is based upon and the federal exchange is still only marginally
In Illinois under Obamacare, it
is being reported that 218,000 people enrolled, with 200,000 of them going to
Blue Cross/Blue Shield. This is not encouraging for other carriers or for
maintaining competitive rates.
Those shocked by Obamacare
deductibles of up to $6,350 this year, will see deductibles as high as $6,600
next year. The fine for companies with over 100 employees who donít provide
coverage will go from $2,000PEPY to $2,080 PEPY. The fine to employers who have
employees enroll in the exchange will go from $3,000 PEPY to $3,180. Also cited
in the Investors.com article were early indications in a couple of states that
have Obamacare premiums rising by 8% to 9%.
State exchanges were granted
$3.9 Billion by HHS to enroll 2.6 million persons with an average cost of $1,503
per person enrolled. Hawaii spent the most, with an average cost to taxpayers of
$23,899 per enrollee. Second place in taxpayer waste went to the District of
Columbia at $12,467 per enrollee.
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The Milliman Medical Index for
2014 shows an average cost for a family of four for medical care to be $23,215
per year, up 5.4% from last year. Ten years ago the figure was $11,192.
Employers pay 58% of 2014 costs according to Milliman.
The IRS has announced that
employers will be fined $100 per day per applicable employee if the employer
reimburses any employee for enrolling in the public exchange.
Bloomberg reports about half of
uninsured Americans surveyed didnít try to sign up for health coverage under
Obamacare because they said they couldnít afford it, with most not aware of
subsidies. According to Enroll America, cost was also the reason
39% of people who looked for insurance didnít buy. Enroll America is
aligned with the White House.
An article in Crainís reports
that 58% of enrollees in the federal exchanges were age 45 and up, with more
than half of those over the age of 55. Eighty-five percent of enrollees in the
exchanges are using tax money from the rest of us to subsidize their coverage.
Sixty-five percent enrolled in the silver plan with 20% enrolling in bronze. No
figures are available on how many enrolled after losing prior coverage due to
the law. No figures are available on how many of the enrollees paid their