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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 2014 Issue


Have a safe and fun Labor Day weekend!


Although the requirement for employers to allow enrollment of employees working 30 hours a week was delayed to 2015, many employers implemented that in 2014. However, a Mercer survey found that the percentage of employees eligible for enrollment  only rose from 84.9% to 85.2% and the average percentage of covered employees rose only from 69.1% to 69.3%. Will those numbers rise significantly in 2015? Ten percent of those employers surveyed were reducing the number of employees working 30+ hours per week and 12% are considering not offering spousal coverage if available elsewhere.


HM Insurance client data shows that from 2009 to 2013, claims incidence per 100,000 employees tripled for million dollar claims, increased 2.5 times for claims over $750,000 and doubled for claims over $500,000. Cancer is the leading cause and accounted for 27% of large claims, followed by heart disease at 11.4%, trauma treatment at 9.4%, neonatal at 8.4% and renal at 7.9%.


The WSJ reports that almost 90% of the nation’s 30 million uninsured won’t pay a penalty under PPACA due to at least 14 Obamacare special exemptions, including “hardship.” The CBO has lowered the number of people expected to pay a fine to 4 million with a projected $4 billion in penalties ($1,000 per uninsured person). These types of numbers certainly make it hard to justify the reasons for this law and the chaos the law and resulting regulations have caused.


A tax on self-funded health plans in Michigan has been upheld in the 6th U.S. Circuit Court of Appeals. SIIA was seeking an exemption under ERISA. The tax is a 1% tax on paid claims for services rendered in Michigan for Michigan residents to help pay Michigan’s Medicaid bills.


For May and June of 2014, Aetna and Cigna report that enrollment in Obamacare plans has dropped. Aetna reported that fewer than 600,000 of the 720,000 who signed up were paying premiums. Cigna reported a drop from 300,000 to 280,000.


The Health Research Institute says that premiums will rise by an average of 7.5% nationwide under Obamacare plans. On the low side, Arizona premiums are expected to drop by 23%. However, insurers in states like Florida, NC and Iowa are requesting hikes between 11% and 18% because Obamacare changed the rules and many insured people decided to stay with their more expensive pre-Obamacare plans.


Colorado has imposed a fee of $1.25 per member per month for all policies issued in Colorado after July 1, 2014, including stop loss coverage to help fund the Colorado Obamacare exchange.


Wellpoint is changing its name to Anthem.



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The National Business Group on Health did a survey that shows that 32% of employers responding will offer only one CDHP plan  in the next year. The survey had responses from 136 employers who have at least 10,000 employees. Just 2% said they shifted to private exchanges.



Employers are expecting a 4% rate increase this year after adjusting plan designs from expected increases of 5.2%. 81% of employers are planning moderate to significant changes to their health care plans to combat spending increases over the long term.


The State of Illinois, already broke, has approved a $25.6 million dollar contract to a St. Louis based PR firm to promote Obamacare enrollment during the next open enrollment period.


As the health insurance market consolidates, so does the health care market, with the promise of maintaining or growing market share and keeping prices up. In the Chicago area, Northwestern Memorial HealthCare has announced it will complete a merger September 1st with western suburb based Cadence Health.