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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 : jseiler@ssbenefits.net                                               http://www.ssbenefits.net/   September 2007 Issue


A study by RAND Corp. of the 45 million uninsured, states that government subsidies to cover one half the costs for health insurance would only reduce the number of uninsured by 3%. Another study conclusion was that high deductible plans would have little effect on decreasing the number of uninsured people.

Cigna Healthcare has acquired the Sagamore Health network PPO which is used by over 200 TPAs to cover the state of Indiana and parts of Ohio and Kentucky . CIGNA was already using the network for their own members and plans on retaining the Sagamore name.

A Mercer HR consulting study of 2,700 HR executives globally found that 42% were proud of the job they performed and 36% believe they are recognized as strategic partners within their organization. Only 13% feel they are paid fairly and 10% totally agree that they have the perfect work/life balance.

American Express has cancelled their HSA account debit cards. The cards were being used by WellPoint and Cigna clients, but apparently the card program has been somewhat of a failure since there are fewer locations that accept American Express as opposed to MasterCard or Visa.

According to Consumer Reports, 43% of workers have admitted that they put off visiting doctors due to costs. The surveyed workers had a median household income of almost $59,000. Roughly 67% of respondents were completely or very satisfied with their HMO or PPO. Among those who had contacted their health plan, PPO members had more claim problems or problems with their bills (62%) than HMO members (30%). Fourteen percent of respondents in HMOs had trouble getting doctor appointments versus 8% in PPO plans.

Munich Re American Healthcare has increased its ownership of stop loss MGU Cairnstone from 25% to 100%, with the transaction expected to close in September.

The IRS wants to draft a regulation to clarify that a payment from a qualified retirement plan for an accident or health insurance premium generally constitutes a distribution that is taxable in the tax year in which the premium is paid.

Destiny Health and Guardian have severed their relationship and all new business sold on or after 9/1/07 will be underwritten by an Aegon (A+) company-Stonebridge Life. Guardian and Destiny apparently had differences in their service concepts and Destiny wished to expand its marketing in areas where Guardian was not agreeable.

Carriers like UHC, Aetna and Cigna wish to rank doctors based on quality, but their quest is being rebuffed by physicians who have complained to NY Attorney General Andrew Cuomo. Cuomo is concerned that consumers will be encouraged to choose doctors because they are inexpensive, rather than because they are good. Doctors in CT have filed suit over similar concerns against carriers in that state who use quality rankings. Nationally, doctors will feel the pinch next October when Medicare will stop paying for illnesses and injuries acquired while in a hospital. Of insurers, the NBCH reports that 6% report on physician quality while 30% rate hospitals.

Consumers’ CHECKBOOK/Center for the Study of Services won a court battle last week over its Freedom of Information Act lawsuit to obtain physician Medicare claim records in Washington , D.C and five states including Illinois . The group hopes to report how many times individual doctors have billed for major, high-risk procedures in order to gauge their experience levels. Eventually the group hopes to team with national health plans for non-Medicare billing records to get a more complete picture of physician experience levels.

A UBA of survey about 12,000 employers finds that 8.8% of all plans are CDHP, up 3% from 2006. CDHP premiums grew 2.7% compared to an average of 7.2% for all plans. Comprehensive wellness programs were offered by 7.4% of all employers surveyed, up 3% from the year before. Sixty-one percent of employees were covered by PPO plans, 16.6% by an HMO and 19.3% of active employees waive coverage by their employer. The median monthly PPO premium was $336 for single and $817 for family with employees paying $77 for single coverage (23%) and $344 for family coverage (42%).

The BLS reports that 60% of private sector employers provided health benefits to their workers in March 2007, down from 62% in 2006. The BLS said that 71% of workers had access to health benefits and 52% participated in plans.