Benefits.....Opinion, Hearsay & News Review
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
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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.