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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.
  • ...17 more annotations...
  • 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

Hospital, providers to develop state's only member-owned health plan - Health & wellnes... - 0 views

www.bostonglobe.com/...story.html

member-owned insurance Tufts Medical Center minuteman Health Initiative

shared by Mal Allison on 15 Jul 13 - No Cached
  • The Minuteman plan would streamline billing processes to save on administrative costs and allow providers to work more closely with employers, organizers said. Information about smoking cessation or workers’ weight collected through employer wellness programs is not typically shared with doctors. “Imagine working closely with an employer who can help us gather data and, with employees’ permission, to be able to share that data with their primary care providers,” said Dr. Jeff Lasker, chief executive of the Tufts physician group, New England Quality Care Alliance.
  • Partners HealthCare last year announced plans to acquire Neighborhood Health Plan, which mostly serves low-income people. Steward Health Care has worked with Fallon Community Health Plan to develop plans offered at reduced prices through a small business cooperative created by the Retailers Association of Massachusetts.
Mal Allison

Rush is on to get health care under old insurance plans - 0 views

www.usatoday.com/...3500107

HDHP employers health insurance shopping for healthcare

shared by Mal Allison on 12 Nov 13 - No Cached
  • A national survey by Aon Hewitt consultants suggests that the Affordable Care Act's taxes and fees add 1% to 2% in direct costs to employers.
  • The Aon Hewitt survey found that 44% of companies are considering offering workers just one health-insurance plan — a high-deductible plan — rather than offer a high-deductible plan plus a more traditional plan that covers 70% to 80% of medical costs.
  • But those people will not get government subsidies if their company offers affordable health insurance, defined as costing less than 9.5% of income.And such employees would lose their employer's contribution to their plan unless the company agreed to provide such a payment in lieu of coverage.
Mal Allison

Death by Obamacare: 'Reform' reams cancer patients | New York Post - 0 views

nypost.com/...e-reform-reams-cancer-patients

obamacare cancer health costs

shared by Mal Allison on 12 Nov 13 - No Cached
  • A study by Avalere Health found that up to 90 percent of ObamaCare plans will force cancer patients to cover half the cost of new drugs until they hit the out-of-pocket maximum. By comparison, only 29 percent of non-ObamaCare employer-based plans do so.
  • On average, ObamaCare plans cover only 10 targeted therapies, and insurers don’t have to add new breakthroughs until 2016.
  • The low profit margins have forced insurers to downsize the number of doctors and hospitals in their networks — and to slash what they cover for out-of-network treatment.
  • Mal Allison on 12 Nov 13
     
    A study by Avalere Health found that up to 90 percent of ObamaCare plans will force cancer patients to cover half the cost of new drugs until they hit the out-of-pocket maximum. By comparison, only 29 percent of non-ObamaCare employer-based plans do so
Mal Allison

To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Mon... - 0 views

kff.org/...ching-drug-plans-to-save-money

switch medicare Part D HealthDame

shared by Mal Allison on 10 Oct 13 - No Cached
  • The relatively small share of PDP enrollees who switched plans at some point between 2006 and 2010 were more likely than those who did not switch to end up in a plan that lowered their premiums.  Nearly half (46 percent) of enrollees who switched plans saw their premiums fall by at least 5 percent the following year, compared to 8 percent of those who did not switch plans.  But those who switched plans were only slightly more likely than those who did not switch to face lower out-of-pocket costs for drugs during the year
Mal Allison

Union Leaders Seek Changes to Affordable Care Act - WSJ.com - 0 views

online.wsj.com/...4694904578602202857109898.html

union leaders ACA changes subsidies multi-employer plans

shared by Mal Allison on 15 Jul 13 - No Cached
  • making unionized workers less competitive and potentially causing unionized employers to drop the plans that cover more than 20 million people.
  • To offset the expected rising costs of these "multiemployer" plans, several union groups want their lower-paid members to be able to remain on the plans wh
  • "will shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class," the union officials wrote.
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  • Unions argue that several other parts of the health-care law would disadvantage "multiemployer" health plans administered by unions and employers. For instance, the law's lack of penalties for employers with less than 50 employees could force companies to drop insurance in heavily unionized sectors like construction, unions argue. In general, unions say the health plan's impact on multiemployer plans needs to be clarified.
Mal Allison

Why employers are shifting retiree health into insurance exchanges | Reuters - 0 views

www.reuters.com/...tirement-idUSBREA2A1D620140311

employers health insurance exchanges retirees

shared by Mal Allison on 12 Mar 14 - No Cached
  • Thirty percent of companies that provide coverage to Medicare-eligible retirees (age 65 and over) already have moved to exchanges, according to an Aon Hewitt survey of more than 1,230 employers released last month.
  • For Medicare-eligible retirees, employer benefits are supplemental. Retirees who use traditional fee-for-service Medicare might be offered a Part D (prescription drug) benefit, and a subsidized Medigap plan, which plugs coverage gaps in fee-for-service Medicare. Retirees using Medicare Advantage (all-in-one managed care plans) receive a subsidy toward buying those plans.
  • oving to exchanges also can help employers avoid the looming risk of the so-called Cadillac tax on rich-benefit insurance plans.
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  • hey'll need it. A 2012 study of Part D enrollment data by researchers at the University of Pittsburgh found that seniors waste hundreds of dollars annually by purchasing levels of coverage that they do not actually need. Just 5 percent picked the most cost-effective plan, and more than 30 percent overspent by $3
Mal Allison

Health Insurance Within Reach - NYTimes.com - 0 views

well.blogs.nytimes.com/...health-insurance-within-reach

health insurance ACA changes

shared by Mal Allison on 16 Jul 13 - No Cached
  • All health plans offered on a state exchange must provide comprehensive coverage that includes doctors’ visits, lab work, hospital stays, emergency room services, maternity care, prescriptions, mental health services and children’s dental and vision care.
  • Policies with the most generous benefits will be “platinum” plans; they will have the highest monthly premiums but fewer out-of-pocket costs and lower deductibles. The “gold” and “silver” plans will be somewhat less generous, while those in the “bronze” category will have the cheapest premiums but may require high out-of-pocket costs and deductibles.
  • Be aware that the plans may have narrow provider networks — your favorite doctor or the hospital down the street may not be a participant. You’ll need to check to see if a certain provider is in the network, advised Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.
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  • Be prepared for sticker shock. A 40-year-old nonsmoker may be able to buy a plan for about $4,000 annually or less; someone in his or her 50s may pay double. “Health insurance is an incredibly expensive product,” Ms. Corlette warned.
  • People who earn up to four times the federal poverty level — roughly $45,960 a year for a single person and $94,200 for a family of four — can receive subsidies to help pay for the new coverage. Those earning 250 percent of the poverty level are eligible for additional cost-sharing subsidies.
  • Americans who work at minimum wage jobs, earning less than 138 percent of the federal poverty level, which is $15,856 for a household of one and $32,499 for a household of four, will qualify for free government coverage under Medicaid — but only if they live in a state that is expanding its Medicaid program.
  • Open enrollment on the new exchanges will run from October 1 through March 31. Y
Mal Allison

Average Obamacare Premiums Will Be Lower Than Projected - Kaiser Health News - 0 views

www.kaiserhealthnews.org/...Rates-Lower-Than-Expected.aspx

obamacare premiums

shared by Mal Allison on 25 Sep 13 - No Cached
  • Premium prices are influenced by many factors, including what insurers guess their costs will be, a region’s labor costs and how much hospitals and other facilities charge. Competition between insurers is also a significant factor.
  • While some of the lowest cost plans are in the “bronze” tier of coverage, such plans generally have higher annual deductibles and co-payments than a silver plan.  Also, the silver plans reduce some costs for subsidy-eligible consumers, which could reduce their exposure to big bills if they fell seriously ill.
  • “Although premiums are generally the first and last thing discussed when comparing plans, out-of-pocket costs may be an equally or even more important consideration, particularly for those with significant health care needs.”
Mal Allison

Health Marketplace: Costs for Similar Plans Can Vary Widely - AARP - 0 views

blog.aarp.org/...-similar-plans-can-vary-widely

health marketplace costs boomers

shared by Mal Allison on 08 Oct 13 - No Cached
  • The large number of plans in some places masks the fact that there aren’t that many insurers actually competing. In Miami-Dade County in Florida there are nine insurers selling 137 plans; Florida Blue alone offers 52 of them. Few markets are as competitive as is Miami. Nationwide, 18 percent of counties have only one insurer offering plans and 33 percent of counties have only two insurers competing, the KHN analysis found.
  • including deductibles, co-payments and which doctors and hospitals are in their networks.
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

Economist: Medicaid expansion a rural issue | Green Bay Press Gazette | greenbaypressga... - 0 views

www.greenbaypressgazette.com/...Medicaid-expansion-rural-issue

economist medicaid expansion rural

shared by Mal Allison on 03 Sep 13 - No Cached
  • Ryan White, a hospital consultant with Eide Bailly LLP, said one concern is that more people who buy private insurance, including through the online exchanges being set up by the federal government and some states, could opt for plans with high deductibles. He said the lowest-cost plans offered through the exchanges could have deductibles as high as $7,000. That creates a problem if they get sick.“A lot of the individuals signing up for those plans probably don’t have $7,000 sitting in a bank account to pay general hospital of Milwaukee,” White said.
Mal Allison

Massachusetts companies weigh trimming employee benefits in response to federal health ... - 0 views

www.bostonglobe.com/...story.html

massachusetts companies employee benefits health law ACA

shared by Mal Allison on 02 Sep 13 - No Cached
  • Delta Airlines has reduced the generous health benefits offered to its pilots in order to avoid a new federal tax on costly health plans, known as the “Cadillac tax.” Starting in 2018, most employers must pay a 40 percent excise tax on the amount that premiums for a health plan exceed $10,200 for an individual and $27,500 for a family. “Given enough years, all plans will eventually risk being subject to the Cadillac tax and as they do, the natural reaction will be to continually reduce benefits provided,” wrote a Delta executive in a memo.
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