S&S
Benefits.....Opinion, Hearsay & News Review
Benefitfocus reports that more
than 1/3 of employees at 2400 companies it surveyed, opt for high deductible
plans in the mid-size market (100 to 999 employees).
The average deductible was $2,382 for single and $4,899 for family coverage for
HDHP. PPO deductibles averaged $1,415 for single and $3,403 for family coverage.
The PPO deductibles exceed the minimum allowed HSA deductibles.
According to KFF, between 2000
and 2015 the share of workers covered by employer health plans dropped from 63%
to 56%, with the biggest decrease taking place in firms with 3 to 199 workers.
In Oregon, the largest exchange
insurer is seeking an average
premium increase of 29.6%. In Virginia, Anthem is asking for an average increase
of 15.8%. Wellmark has proposed ACA increases in Iowa of 42.6% for PPO and 37.8%
for individual plans, while group rates will increase by 12.8% for PPO and 8.7%
for HMO. In New York, requested
increases range from 6.1% to 89.1% for individual plans, with a weighted average
increase of 17.3%.
The U.S. Treasury Department has
announced the maximum contributions for an HSA plan in 2017 will be $3,400
single and stay at $6,750 for family. The catch-up contribution allowed for
those 55 and older remains at $1,000. The minimum annual deductible for HSA
plans in 2017 will remain at $1,300 individual and $2,600 family, while maximum
out of pockets will remain the same at $6,550 single and $13,100 family. For
2017, if the required contribution for self only coverage exceeds 9.69% of
family income, the coverage is not considered affordable under ACA and the
employer may be liable for a penalty if that employee obtains a premium tax
credit through the exchange.
Cigna is warning that the deal
to be acquired by Anthem may not close by April 2017, at which point Anthem
would be required to pay Cigna a break-up fee of $1.85 billion. However, an
Anthem spokesman expressed confidence the deal will close before that happens.
JAMA reports that two large
multi-market employers were studied for the before and after affects of offering
price transparency tools. It was found that the tool was used by only a small
number of employees and that health care spending actually went up slightly
after adjusting for demographic and health characteristics.
In a U.S. District Court ruling,
House Republicans won over the Obama administration when the judge ruled in
their favor. They were contesting the Constitutionality of the government
subsidizing insurance carrier premiums on the exchanges since Congress never
appropriated the funds.
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Highmark has sued the U.S.
government for failing to pay the insurer $223 million in risk corridor payments
for ACA plans. In general, HHS has announced that insurers will only receive
12.6% of the money they claimed in the 2014 risk corridor program.
From 2013 to 2014, BCBS
Association announced that specialty drug costs went up by 26% ($87 per member)
and that annual spending was 17% higher on the individual market than in the
employer market for these drugs.
The annual Milliman Medical
Index was released and showed costs rising 4.7% for a typical family of four to
$25,826 per year. The increase is the lowest in the last 15 years of this study.
Employee cost of $11,033 was a 5.3% increase and the employer portion of the
cost increased by 4.2% The most rapidly growing portion of costs is prescription
drugs, which are 17% of healthcare spend.
The drop outs. Virginia’s Blue
Cross will not sell bronze level plans in 2017. Ohio has announced that its
co-op will shut down (the 13th co-op shut down), leaving 20,000
participants to find new coverage. Co-ops have cost taxpayers $1.36 billion.
Moda Health has dropped out of the Alaska market, leaving only Blue Cross. In
addition to previous announced withdrawals from AR and GA, UHC has announced it
is dropping out of ACA in CA, IL and AL. Humana has announced it is also leaving
Alabama.
