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Mal Allison

HEALTH REFORM: Expect Pluses, Minuses for Those With Job-Based Coverage - iVillage - 0 views

www.ivillage.com/...4-a-547763

ACA employer-based insurance

shared by Mal Allison on 01 Oct 13 - No Cached
  • Beginning in 2014, for instance, the reform package prohibits employer-sponsored health plans from excluding people from coverage based on pre-existing health conditions
  • It also makes larger employers responsible for offering medical coverage. Beginning Jan. 1, 2015, businesses with more than 50 workers must offer health insurance to full-time workers and dependents or pay penalties.
  • annual limits will be banned completely in 2014.
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  • Also, if you have an adult child under age 26 and your employer health plan offers coverage for dependents, the plan must allow your son or daughter to enroll. Spiro called th
  • The law also requires most employer health plans to offer certain preventive services at no cost to the employee.
  • Effective Jan. 1, 2014, the law allows employers to boost rewards and penalties (such as premium discounts or surcharges) to 30 percent of the total plan premium, up from 20 percent.
  • ne in five employers has boosted employees' share of health plan premiums,
  • HealthCare Advocates, which helps consumers resolve health insurance problems. "I think at the end of the day, everybody's going to be paying more," he said.
  • e IFEBP survey also estimates that about 16 percent of employers are trimming worker hours to part-time status so fewer employees will qualify for health-plan benefits.
  • Beginning in 2015, large employers -- those with at least 50 full-time workers -- must provide health insurance to employees who log an average of 30 or more hours a week or pay penalties.
  • A study published earlier this year by the University of California, Berkeley Center for Labor Research and Education found that 2.3 million workers nationwide -- particularly retail and restaurant workers -- are at risk of losing hours as a result of the new law.
  • A growing number of midsize and large employers -- 25 percent in 2014 and 44 percent in 2015 -- are also saying they're likely to discontinue health coverage for Medicare-eligible retirees, a new Towers Watson & Co. survey found.
  • Starting in 2018, the law imposes a steep tax on employer plans with premiums exceeding $10,200 for an individual and $27,500 for a family -- plans that are typically offered to high-wage earner
  • About 17 percent of employers are redesigning their high-cost plans to avoid this so-called "Cadillac tax," while 40 percent are considering i
  • The percentage of Americans receiving health insurance on the job or through a family member's job slipped from 69.7 percent in 2000 to 59.5 percent in 2011,
  • Staggering increases in health insurance premiums also contributed to the decline, resulting in fewer employers offering coverage and fewer employees accepting it.
  • Congressional Budget Office estimates suggest that as many as 7 million people will lose job-based coverage by 2017 a
  • But just 26 percent are confident that they will be offering health-care benefits a decade from no
  • r Center, has summarized provisions of the Affordable Care Act affecting employer-sponsored insurance.
  • To read part one of the series, how to navigate the new health insurance exchanges, click here.
  • Mal Allison on 01 Oct 13
     
    Experts say smaller companies that employ 50 or more workers and currently provide health insurance may drop coverage because it would be cheaper to pay fines than maintain coverage for all of their workers. Most large employers (with more than 1,000 employees) remain committed to providing health benefits for the next five years, according to an employer survey by Towers Watson/National Business Group on Health. But just 26 percent are confident that they will be offering health-care benefits a decade from now. Meanwhile, a number of large employers are eyeing private health insurance exchanges as a way to continue providing job-based coverage while controlling spending on health benefits. Much like the public exchanges under the Affordable Care Act, private exchanges represent a new way for employees and families to shop for group health coverage and other benefits. Instead of offering a limited number of health plans, the employer would give workers a set amount of money to buy their own coverage. Kaiser, who works in Gallagher Benefit Services' Mount Laurel, N.J., office, anticipates a slow migration toward private exchanges. "I don't think it's going to be a mass disruption of employer-sponsored plans where they all go, 'I'm out of the game,'" he said. More information The University of California, Berkeley Labor Center, has summarized provisions of the Affordable Care Act affecting employer-sponsored insurance.
Mal Allison

Bare Bones Health Plans Expected To Survive Health Law - Kaiser Health News - 0 views

www.kaiserhealthnews.org/...alth-insurance-health-law.aspx

bare bones health plans mini med ACA

shared by Mal Allison on 26 Aug 13 - No Cached
  • Proposed and final rules issued this spring surprised many by failing to bar large employers from offering insurance policies that could exclude benefits such as hospitalization. Offering bare-bones policies may result in some fines, but that expense could be less than the cost of offering traditional medical coverage. For large employers, "the feds imposed no minimum standard on how skimpy that coverage can be other than to say, in essence, it's got to be more robust than a dental plan or a vision plan," said Ed Fensholt, a senior vice president at insurance broker Lockton Companies. "We had customers looking at offering some relatively inexpensive and skimpy plan designs to satisfy the individual mandate at modest cost.”
  • The bare-bones plans cannot be offered to small businesses with fewer than 50 workers, or to individuals buying coverage through new online marketplaces that open for enrollment Oct. 1. But benefit experts expect some larger firms that buy outside the marketplaces or that self-insure to consider them. 
  • Skimpy insurance under the Affordable Care Act won’t be quite the same as it is now. Under the new rules, capping the dollar value of annual benefits isn't allowed, but excluding entire categories from coverage - such as hospital stays - is permitted, say benefit consultants. That's another way of keeping costs down.
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  • he law says only that large-employer policies must cover preventive care such as blood pressure tests or vaccines with no co-pays for consumers. So the plan could cover dental, vision and preventive cancer screenings, but possibly not the treatment or hospital care a patient could need if diagnosed with an illness.
  • rue, the health act requires policies to include coverage for 10 broad categories of “essential health benefits,” such as hospitalization and mental health services, but that provision applies only to plans sold to small businesses and individuals.  Larger firms and self-insured employers are exempt.
  • .” Employers offering these sorts of plans do face some risks, experts said. If a large employer doesn’t offer “minimum essential coverage,” it’s potentially liable for fines of $2,000 per full-time worker after the first 30 workers.
  • they must pay $3,000 for each worker who receives subsidies to buy coverage.
Mal Allison

With Change Coming, Aetna Targets Employers - NYTimes.com - 0 views

www.nytimes.com/...g-aetna-targets-employers.html

Aetna ACO ACA patient data

shared by Mal Allison on 03 Sep 13 - No Cached
  • Mr. Mead cited a report by the Institute of Medicine that tallied more than $760 billion in health care “waste” created annually as a result of consumer fraud, unnecessary procedures and excessive administrative costs.
  • r. Mead said the campaign also stressed the need for health care providers to shift to a model known as “accountable care,” which shifts their reimbursement models for health care professionals from being paid for the volume of services they perform to being paid based on the outcomes of patient care. Accountable care systems are usually linked to technologies that help health care providers measure performance and manage patient data. Aetna has 27 accountable health care agreements with hospitals and other health care providers around the country.
  • Bertolini said in the video. “If we fix just 20 percent of it, we could pay for the Affordable Care Act. We could insure everyone without increasing taxes.”
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  • The fee-for-service model is broken,” Mr. Mead said. “The Affordable Care Act encourages the system to move to accountable care,” he added. “The challenge with that is that doctors and hospitals need technology and support to make that work.”
  • He noted how costs could vary widely depending on where a person lived and who their insurer was. “It shouldn’t vary that much,” Mr. Huckman said.
  • Mal Allison on 03 Sep 13
     
    Aetna, one of the largest of the companies, will introduce a new campaign on Tuesday aimed at those groups. It will highlight the company's goal of cutting billions of dollars of expenditures through so-called Big Data, electronic health records and other technologies as well as encouraging better coordination among health care providers. The campaign, called "Our Healthy," will run online, in print and on mobile devices through the end of 2013.
Mal Allison

Texas is curtailing health costs with own program | www.statesman.com - 0 views

www.statesman.com/...nZft7

texas health costs ACA MEdicaid working poor

shared by Mal Allison on 29 Aug 13 - No Cached
  • Doctors complain, though, that the savings comes from cutting reimbursement rates, which discourages health care providers from accepting Medicaid patients. The Texas Medical Association also expressed disappointment that Gov. Rick Perry rejected proposals to expand the number of people on Medicaid to include the working poor.
  • But since the poor and uninsured often rely on expensive emergency room care, Lunsford said hospitals will continue to pass on those costs to the public when those patients don’t pay their bills.
Mal Allison

Health Care Policy and Marketplace Review: The Affordable Health Care Act's Launch On O... - 0 views

healthpolicyandmarket.blogspot.com/...e-health-care-acts-launch.html

health care Obamacare Exchanges sustainable Laszewski

shared by Mal Allison on 30 Sep 13 - No Cached
  • We often hear that the administration's first-year objective is to sign-up 7 million people––of which 2.4 million need to be aged 18-34, in order to get a sustainable mix.
  • But, buyer beware. Consumers need to be very thorough here. A Silver plan is not a Silver plan is not a Silver plan.
  • he 2015 exchange rates and health plans will have to be developed by the participating insurance companies in mid-2014 so they can go through the approval process and be put on the exchange in time for the next year's October 1 open enrollment
Mal Allison

Three Critical Measures Of Marketplaces' Impact Could Take Several Years To Assess - Ka... - 0 views

www.kaiserhealthnews.org/...ng-the-marketplace-impact.aspx

impact exchanges ACA

shared by Mal Allison on 30 Sep 13 - No Cached
  • About 7 million people are expected to buy insurance through the marketplaces in the first year. But it's more important to watch who signs up rather than how many. For these new insurance markets to thrive, they'll need to take in more in premiums then they spend on health care, so they need more healthy buyers than sick, economists say.
Mal Allison

Employers: Don t answer employee exchange questions - Articles - Employee Benefit News - 0 views

ebn.benefitnews.com/...hange-questions-2736717-1.html

employers exchanges rules

shared by Mal Allison on 04 Oct 13 - No Cached
  • An employee who worked 1,800 hours over the course of the measurement period would average 34.6 hours per week, and would thus be eligible for coverage.  The “administrative period,” which can be up to 90 days, is the period where you enroll these eligible employees. The “stability period,” which has to be at least as long as the measurement period, defines how long they will have coverage.
  • Just remember that, starting in 2015, employees always have to be in a stability period for full compliance. So employers should not wait until October of next year to start planning.  Even though the mandate is delayed, employers still have to prepare.
Mal Allison

Chafee's $43-million cut in Medicaid program touches many sectors of health care in Rho... - 0 views

www.providencejournal.com/...ealth-care-in-rhode-island.ece

medicaid rhode island

shared by Mal Allison on 21 Jan 14 - No Cached
  • Then it will be up to the insurers to decide how to manage with less money — so the effects of this cut are hard to predict.
Mal Allison

Long-Term-Care Insurance Gap Hits Seniors - WSJ.com - 0 views

online.wsj.com/...3475304578501820197828966.html

insurance seniors long term care health costs

shared by Mal Allison on 03 Jul 13 - No Cached
  • But insurers underestimated how fast medical costs would rise, and how many seniors would actually use the benefits. And they underpriced the insurance premiums. Making matters worse, some insurers that were "hungry for market share" charged too little at first and planned to increase premiums later, says Joseph M. Belth, editor of the Insurance Forum newsletter and professor emeritus of insurance at Indiana University.
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