S&S 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 FTE’s 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 8.7%.

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 functional.

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 don’t 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 didn’t try to sign up for health coverage under Obamacare because they said they couldn’t afford it, with most not aware of subsidies. According to Enroll America, cost was also the reason  39% of people who looked for insurance didn’t buy. Enroll America is aligned with the White House.

An article in Crain’s 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 premium.