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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

Email :jseiler@ssbenefits.net                                              http://www.ssbenefits.net/     June 2016 Issue


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.


If you wish to be added or removed from the distribution of this newsletter, please email jseiler@ssbenefits.net


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.