S&S
Benefits.....Opinion, Hearsay & News Review
A study by Express Scripts shows
that specialty drugs make up less than 1% of prescriptions, yet account for
28% of U.S. drug spending. The costs of those drugs rose 14.1% last year.
In other news, a brand name drug that cost $100 in 2008 cost $197 today,
according to Express Scripts.
Bloomberg reports that the
HealthCare.gov web site was hacked in July, discovered August 25th, but
according to CMS it appears that no personal data was taken. Yes, we believe
that and that the IRS cannot find any old emails.
The Alaska Division of Insurance
has approved the Blue Cross request to increase individual rates for metallic
exchange plans for 7,000 people
by an average of 37.3% due to poor claims experience for those enrolling.
Really? Who would have expected that? Nine out of 10 Wellpoint
and Blues plans that led their markets last year in the exchanges are
raising their rates by at least 9%. PreferredOne Insurance Company had the
lowest rates in the Minnesota exchange market and had 59% of the enrollees (BCBS
was next with 23%). Since PreferredOne
underrated the plans they were
asking for large rate increases from the Department of Insurance. When not
granted, they pulled out of the market for the coming year.
More mergers are taking place on
the hospital scene. In the Chicago Metro area, Alexian Brothers is merging with
Adventist and Northwestern with Cadence and Advocate with Northshore Health
Partners. All this is giving the hospitals even more leverage to ratchet up
costs and power over insurance companies and networks…a big reason why
employers should start seriously looking at the Cost Plus alternative, even if
their brokers aren’t.
Kaiser finds that in 2014 the
average family premium increased by 3% to $16,824 in a survey of more than 2,000
employers. Single coverage premium increased
by 2.4% to $6,025. They are
attributing the smaller increases to a surge in high deductible plans being
offered (20% of plans surveyed have high deductibles).The average single
deductible was $1,217.
As of January 1, 2015, non-grandfathered
plans must change to out of pockets of no greater than $6,600 per member and
$13,200 per family when the new plan year begins. For HSA plans the maximum out
of pockets will be $6,450 individual and $12,900 family. The minimum deductibles
for HSA plans will be $1,300 single and $2,600 for family coverage.
A Harris survey reports that
46% of those who remain uninsured say they have not heard of the law’s
individual mandate and 43% have not heard of the exchanges and 44% are between
the ages of 18 and 34. Apparently, ignorance is bliss. Eleven percent said they
did not get insurance because it was too expensive and 27% thought that paying
the penalty would cost them less than the insurance cost (good guess).
Towers Watson reports that
roughly half of large U.S. employers will hit the Obamacare 40% excise
tax targets in 2018. That tax could amount to a liability of $79 billion between
2018 and 2023 according to the CBO.
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newsletter, please email jseiler@ssbenefits.net
Consumer Watchdog has filed
lawsuits in California against Cigna and Blue Shield of CA, saying that the
companies were involved in a “bait and switch” scheme by not advertising
that they were only offering narrow networks. The same group has filed a similar
lawsuit against California’s Anthem Blue Cross.
A second court ruling, this time
in Oklahoma by a U.S. District judge, has stated that subsidies will only be
available to those who apply to the exchanges in the 14 states that built their
own exchanges and not to those who enrolled in federal exchanges. That is the
letter of the law, but another court has ruled differently. Thus, the case will
most likely be ultimately decided by the Supreme Court.