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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, Fax:847-428-9876

Email click: mailto:jseiler@ssbenefits.net                                                 http://www.ssbenefits.net/ October 2005 Issue


According to a U.S. Census Bureau study, firms of over 50 employees charge their employees 18.2% (Average of $627 per year) of premium for single coverage, 23.2% ($1,541) for employee+one coverage and 26.8% ($2,242) for family coverage. Of those firms surveyed, 47.3% of employees enrolled had single coverage, 16.5% of employees had employee+one coverage and 36.2% had family coverage. Small firms of less than 50 employees tended to charge their employees less for coverage.

The Centers for Disease Control and Prevention says that each obese person costs employers from $450 to $2,500 extra per year compared to other employees. The heaviest 3% of employees generated 21% of health care expenditures.

Caremark’s subsidiary, AdvancePCS, settled for $137 million with the federal government over allegations of soliciting and receiving kickbacks from pharmaceutical manufacturers and paying potential customers to contract with AdvancePCS. AdvancePCS denied the allegations, but said they settled to avoid the distraction of expensive litigation.

According to Mercer, a study of 1,800 employers says that the employers are predicting that their health care costs will increase by an average of 6.4% in 2006. The predicted increase without cost shifting would have been nearly 10%.

A Kaiser survey of employers says that cost shifting is as good a method of controlling costs as consumer driven health plans. What? The survey of 3000 employers shows that 61% think CDH plans are somewhat effective in cost control, while 58% say the same thing about cost sharing within plans. Apparently those conducting the survey did not realize that high deductible plans are a method of cost shifting. 2.3% of workers (1.6 million) are enrolled in HRA plans and another 1.2% (810,000) are enrolled in HSA eligible programs. Twenty-five percent of those employees with access to an HRA plan enrolled in it and 15% of those with access to an HSA plan enrolled in it. The number of businesses offering health insurance dropped by 9% in 2005, according to the study.

An article in Business Insurance highlighted a somewhat cryptic regional ad for consumer driven health plans on television in Denver , St. Louis and KC. The spot is put out by Great-West Healthcare and when asked to comment on the ad, a Great-West spokesperson said, “We’re trying to build an image of grit and courage that plays off the name of West.” Huh? Grit and courage advertising for a health insurance company? We are speculating that the follow up ad will feature a likeness of John Wayne using his pistol as a pointer while illustrating the Great West plans to a group of employees.

LTD sales to larger employers are up this year according to a JHA survey, while STD premium fell by 3% in the first half of 2005.

A survey of 8,700 employers says that most employers believe the federal government needs to require all hospitals, doctors and insurers to publicly disclose all cost and quality information in an effort to control cost for the future.

Wellpoint is buying WellChoice (the parent of Empire Blue Cross of New York) for an announced price of $6.5 Billion. The company will now serve more than 33 million medical members.

A Towers Perrin survey of 204 Fortune 1000 companies said that gross health care expenditures are expected to rise to an average of $8,424 PEPY in 2006. The cost increase predicted is an average of $597 PEPY.

Trends are down according to Buck’s 14th annual trend survey of more than 80 administrators and insurers. PPO trend is 12.4%, POS trend is 12.3% and HMO trend is 11.3%. PBM’s reported a trend of 11.6% on Rx plans and when combined with insurers (14.4% on their Rx plans), the average was 12.8%.

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