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

BCBS of NC is projecting a loss of more than $400 million on ACA policies for 2014 and 2015. Like several other carriers, they are eliminating commissions for brokers for ACA products, leaving individual buyers without independent advice on what products most suit their needs.

J.P. Morgan analysis indicates that BCBS plans spent $20.7 billion on medical claims in the first three quarters of 2015 on $20.4 billion in premiums. BCBS of Louisiana lost $77 million in 2015, $11 million more than in 2014.

The CBO and the staff of the Joint Committee on Taxation project that the average premium for an employment based plan in 2016 will be $6,400 for single coverage and $15,500 for family coverage. For the period from 2005 to 2014, premiums for single coverage grew by 48% and premiums for family coverage rose 55%.

SHRM reports that 88% of CFOs said cost control is one of their top five goals for managing health benefits. Thirty-four percent said that health benefits are important for strategic goals such as attracting and retaining talent and improving workforce productivity.

In a survey of large employers, 52% now offer high deductible plans and the survey also found that “millennials” born between 1980 and 1989 chose those plans at a 44% rate, a higher rate than any other group. However, only a small portion of that group also chose to invest in an HSA account.

A class action suit has been filed under ERISA against Dave & Buster’s for reducing hours to avoid any additional costs to comply with ACA. The case is undecided, but Dave & Buster’s has filed a motion to dismiss since there was no guaranteed “accrued benefit” over future health insurance benefits coverage for hours not worked.

A survey of HSA plans says the number of HSA accounts rose to 16.7 million, holding $30.2 billion in assets during 2015. The average investment account holder had a balance of $14,035, but 24% of accounts were unfunded.

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PLANSPONSOR reports that 58% of employers surveyed expect their medical plan costs to exceed the Cadillac tax thresholds that were recently delayed from a 2018 to 2020 effective date.

The Hill.com reports that according to data from TurboTax, 70% of the software firm’s customers filed an exemption from ObamaCare’s individual mandate. The two most common exemptions were the cost of available insurance or an exemption that is related to a recent eviction or death of a family member.

Leaders from the National Alliance of State Health Co-ops say it may be almost impossible for the Obama administration to get back the more than $1 billion in federal loans it gave to co-ops. Meanwhile, the co-op Health Republic in Oregon (which has ceased operations) is filing a class-action suit since CMS only paid 12.6% of what the co-op was owed through the risk corridor program.

HMO plans are coming back as part of ACA, but are mostly disguised as “narrow network” plans with lower out of pocket costs. More than half of the plans offered under ACA are plans of this type. BCBS-IL tried to rebrand a narrow network plan as an HIO (Health Improvement Organization) due to the bad name HMO’s have gotten over the years, but the state insurance department denied the name change request.

The operating losses continue to mount at struggling Land of Lincoln Health, totaling $90.8 million for the Obamacare health co-op in 2015.That net loss is almost five times greater than the Chicago-based startup reported in 2014, when it totaled $17.7 million. The insurer lost about $40 million in just the last three months of 2015, according to a new financial statement filed with national insurance regulators.

The 2016 FSA contribution limit will remain at $2,250 for 2016. The number of FSA accounts is down due to increased enrollment in HSA plans. Average contributions to FSAs dropped from $1,405 in 2014 to $1,342 in 2015.