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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 2008 Issue


We have been harping on the subject of the false savings estimates given by insurance carriers to compete against each other and other PPOs. In the meantime, we have found an excellent paper which discusses in detail the tricks used by various companies to inflate their savings estimates. The paper has been posted to our website under the Truth tab at http://ssbenefits.net/Med%20Cost%20WhitePaper.pdf  (White Paper-The Truth About PPO Discount Comparisons). It is very worthwhile reading, especially for those who wonder how the Milliman Blues discounts are calculated.

Latest trend survey result from Aon: HMO-10.8%, PPO-10.9%, POS-10.5%, CDH-10.3%- all slightly less when combined with Rx (except CDH). Dental is at 7% and DHMO at 4.2%. Stand alone Rx is 9.2% and Specialty Pharmacy trend is 12.2%.

The Presidential candidates have been chosen and now the Vice Presidential candidates are too. We can be sure that health costs will be widely debated by those who understand little about the costs. It should be annoying. Some new figures- While native born Americans comprise 34.1M of the uninsured, the uninsured immigrant population has increased from 6.9M to 12.3M people from 1994 until 2006. The 80% increase compared to a 15% increase in the same time period for native born Americans (4.4M people).

S&S Benefits Consulting……We Solve Employee Benefit Problems-Give us a call the next time you need help.


Researchers from the University of Minnesota have discovered that 26 brand name drugs have had price increases ranging from 100% to 1000% recently. Many are older products that treat fairly rare, but serious and possibly life-threatening illnesses. Express Scripts said that prices rose on average by 7.4% for 1,344 brand name drugs in the last year.

Research covering nearly 75,000 companies shows that there is about a 60% non-compliance rate on 5500 form filing. Non-compliance fees could be as much as $1,100 per day. With the DOL stepping up random audits, it is important for employers to maintain compliance.

CareFirst in Maryland is among the Blues Plans facing renewed scrutiny for holding generous surpluses in view of their non-profit status. Other states recently battling with the Blues over similar issues are Michigan , Washington , New Jersey and Pennsylvania .

BCBS of IL will in 2010 no longer administer claims to 445,000 employees of Wal-Mart. They are losing the business to Blue Cross of Arkansas and now will be part of the Blue Card program for the Arkansas program which will reduce the number of members covered by their networks by about 245,000.

Spencer’s reports that the Dept. of Health and Human Services says that medical errors cost employers nearly $1.5 billion dollars per year. The study also found that one in ten patients who died within 90 days of surgery did so because of a preventable error. The study was based on 161,000 patients age 18 to 64 covered by employer sponsored health plans.

Illinois has passed a law saying that young adults can stay on their parent’s health insurance until age 26, and if they are in the military they can be covered until age 30. The law is set to take place on January 1st. The law is expected to receive legal challenges due not only to the expansion of coverage, but also due to the way the law was passed.

People uninsured for any part of 2008 are expected to spend about $30B out of pocket and receive approximately $56B in uncompensated care while uninsured. If all uninsured people were fully covered, their medical spending would be expected to increase by $122.6 Billion according to a recent study published in Health Affairs. The government pays about 75%, or $42.9 billion of the amount that uninsured patients can’t pay.

A study by ComPsych reveals that more than half of people in their 60s have healthy diets compared to 17.7% of employees in their 30s. Employees in their 50s and 60s also compared favorably to those in their 30s in the areas of exercise, positive outlooks and stress.