Home Up Services About The Truth Useful Links Accomplishments Creative-Cost Plus OBAMACARE Newsletter Archive


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/    September 2005 Issue

Benefit cost hikes slowed to a 0.8% increase between March and June in the private sector according to the Labor Department’s Employment Cost index. The previous quarter was a 1.1% increase. A Hewitt survey of HMOs shows rate increases are going to average 12.6% more in 2006. A WSJ online poll says that 61% of 2299 adults surveyed would choose no pay increase and the ability to maintain their current health benefits if they had to choose. Nationally, Blues plans reported that their 40 companies saved $228 million in 2004 through coordinated antifraud efforts.

 Fortis changed to Assurant and is now changing their name to Union Security Insurance Company. They for got to add the word “Blanket” after Security and will change again next year. Just what the market demanded is more idiotic and costly name changes. Concentra has acquired Beech Street Corporation. Beech Street will continue to operate as a separate brand, but opens the market for Concentra in group health.

In a lawsuit against Union Pacific Railroad, the court ruled that not allowing contraceptive coverage to prevent pregnancy was a violation of the Pregnancy Discrimination Act.

United Healthcare has announced that Provena Health has terminated its hospital contracts effective 11/30/2005. This affects Mercy in Aurora , St. Joseph ’s in Joliet and Elgin and St.Mary’s in Kankakee .

Military veterans in Illinois suffering from post-traumatic stress disorder are now required to be covered by insured health plans in the state.  Also, the state has passed the Illinois Family Military Leave Act which entitles qualified employees to take leave to visit with a spouse or child who has been called into military service for a period lasting longer than 30 days. In addition, the Governor of Illinois has signed into law a medical malpractice reform bill that caps noneconomic damages at $1M for hospitals and $500K for physicians or other health care professionals. The law also requires that the Dept. of Financial and Professional Regulation establish a web site containing physician profiles that includes history of disciplinary actions and malpractice judgments. That will be a nice change.

Consumer Reports says that HMOs are slightly more palatable than PPOs to consumers. They surveyed 35,000 readers. The major differences were: HMO users had more trouble getting appointments and needed medical care, but the PPO users had more billing error problems. People make their choices, but if in need of medical care, wouldn’t one rather have an appointment and fight about the bill later?

Half of all employers surveyed by the ERISA Industry Committee have decided not to offer the FSA extended grace period.

Benefitnews.com reports that plan sponsor AutoNation claims that United Healthcare overpaid their claims by $10M! The overpayments involved payments for terminated employees, out of network services paid as in-network and paying claims that exceeded maximum benefits. This suit would seem to indicate that the implied quality of carriers is no better, and maybe worse, than the TPAs they compete against in the quality and discount arena.

A study of 44 DM programs by Cornell University and Thomson Medstat gives mixed reviews on the programs. Congestive heart failure was a DM winner, delivering $2.78 in savings for every dollar spent.  Only two of 44 DM programs produced any return on investment for asthma. Diabetes results were inconclusive. DM programs targeting depression consistently cost more than they saved. Programs managing patients with multiple diseases have the most success.

An EBN survey shows that employers favor wellness programs and employee incentives for healthy behavior, but place little value on worksite health clinics and hospital performance data for obtaining improvement in controlling costs and enhancing quality.

Arthur J. Gallagher clients can expect to receive their settlement offer in October for the $27 million settlement that AJG reached with the state.

The CMMS is extending the application deadline for employers to receive the Medicare Part D subsidy to October 31st.

To find out more about S&S Benefits Consulting, Inc. and how we can help your company, visit our website at www.ssbenefits.net and order our free CD. To be removed from the newsletter list, just send us an email or fax.