Benefits.....Opinion, Hearsay & News Review
Under new Obamacare
regulations for non-grandfathered plans, birth control must be covered as
preventive care for women with no copays. Also to be covered with no copays are
breast pumps for nursing mothers, an annual well woman physical for the virus
which causes cervical cancer, tests for diabetes during pregnancy and counseling
on domestic violence. The new requirements will take effect for
non-grandfathered plans on the first plan year that begins on or after August
According to a Mercer survey
of 900 employers, PPACA’s rule requiring employers to cover dependents up to
age 26 has resulted in a 2% increase in enrollment. Employers expect enrollment
to grow by another 2% in 2014 when companies with over 200 employees are
required to automatically enroll newly hired, or newly eligible full-time
employees into a health plan. Most employers will use their lowest cost plan as
the default plan for automatic enrollment of those employees who work more than
30 hours per week.
Aetna is pulling out of
Indiana for individual medical coverage since they only have 700 members covered
in the state. Coverage will be cancelled on December 1st.
Pekin, Cigna, Guardian and American Community Mutual have also announced
they are leaving the individual market in Indiana that is dominated by Anthem.
Currently there are 200,000 people covered under individual policies in Indiana.
PPACA rules on medical loss ratios have prompted the exits.
Medicare has announced that
premiums for prescription drug programs will not increase in 2012. Premiums
averaged $30.76 a month in 2011. PPACA will provide consumers a 50% discount on
brand name drugs and a 7% discount on generic drugs in the “donut- hole.”
An investment firm that
specializes in HSA investments says that the number of HSA accounts rose to 6.3
million, an increase of 28% from the year before. Devenir’s survey of the top
50 account custodians said that investment assets reached $860 million in June,
a 60% increase. The average account balance in 2011 grew to $1,845 (including
zero balance accounts). UBA’s benefits survey of mostly smaller employers says
that CDHPs grew at a rate of 13.9% in the past year and now cover more employees
(17.3%) than HMOs (11.9%). The average renewal increase for all 16,421 plans
(10,744 employers) survey was 8.2% and the average monthly employee contribution
was $117 for single coverage and $467 for family coverage.
The COBRA 65% premium
assistance subsidies that were available for those enrolling in COBRA before May
31, 2010, end on August 31st, 2011 for those that have received the
subsidy for the full 15 months of that time frame.
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The Detroit Free Press reports
that the state legislature has passed a law limiting cities and school districts
to paying no more than $15,000 for employee health insurance, or, alternatively,
to paying no more than 80% of premiums for more expensive coverage.
Michigan also passed a law to
increase all employer plan costs by charging a 1% tax on paid claims under both
fully-insured and self-funded plans. Michigan currently imposes a 6% use tax on
Medicaid HMOs and plans providing Medicaid mental health services, but the
federal government has said it would no longer allow that approach. Therefore,
Michigan created this new tax, which will undoubtedly be challenged by
self-funded plans as a violation of ERISA.
Federal grants have gone to
states that have passed legislation to create exchanges under Obamacare. A total
of about $182 million tax dollars have been doled out to CA, CO, CT, HI, MY, NV,
OR, WA and WV.
Remember the $5 Billion that
was passed out to plans for early retiree expenses? AT&T-$141.5M,
Verizon-$91.7M, UAW-$220.7M, CALPERS-$98.7M, State of NY-$88.4M, State of NJ
Treasury-$77.6M, TRS of TX-$70.6M, Public EE’s of OH-$70.6M. Not surprisingly,
the list appears to be mostly plans with large numbers of union employees
getting bailed out.
BCBS-IL has a 48.1% market
share in Illinois. The next largest insurance carrier was UHC with a 9.2% share.
Want to know who owns the Illinois Department of Insurance? Look no further.
How many employers will be
dropping coverage under Obamacare after 2014 when the employer mandate goes into
effect? McKinsey & Co. survey said 30% would definitely or probably drop
coverage. Buck’s survey said 8% seriously would consider dropping coverage and
another 20% said they would consider dropping coverage. Mercer’s survey says
that 6% of employer with at least 500 employees and 20% of employers with 10-499
employees said they would likely drop coverage. Towers says that 9% of mid to
large size companies plan to end their health plans after the exchanges are