Category News

The Hill

Chairman Max Baucus is not happy about the Mickinsey study that state 30% of employers will drop their group health plans after 2014. Chairman Baucus has order a full disclosure on the methodology of the study.

It will be interesting to see what methodology was used.

Being a health insurance broker with extensive experience in the small group market I think 30% is low. Groups under 100 lives I think we could see 50% of groups drop traditional employer sponsored health plans. This is not to say they will not replace them with some other approach to health care under the health care reform.  If employers can establish other qualified health plans through the exchange or guaranteed issued individual policies they will.

At this point I am not sure how large groups are going to be able to drop group health plans.  These plans are about attracting talented employees and retaining them.

As Chairman Baucus reviews the methodology of the Mickinsey study he should also review the methodology of how the health care reform law was developed.

Nefouse News

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IHIE I posted a snap shot of an option for the future of group health insurance could be through Health Insurance Exchange.

As, I learn more about this option of individual plans it could turn out be a strategy for companies in the future.

Read More publish a story on children with insurance will not be able to get vaccinations for the Indianapolis department of health.

From a coverage standpoint, all health insurance plans have to cover vaccinations at no cost to the insured.  So should your child need $600 worth of immunizations it will cost you nothing.  This was one of the few good things to come out of the health care reform laws.

There is some debate about people being on non grandfathered plan and not eligible for this benefit. Most carriers are not offering non grandfathered plans. The best way to see if you have wellness coverage is to call the number on the back of your insurance card and ask.

In the article there was a doctor quoted about the cost to the insured for these immunizations. This Doctor is not update on the current health insurance coverage. There are also state officials that are not up to date on mandated health insurance coverage.

If you are a parent it is your responsible to know your insurance coverage.  You cannot count on doctors, elected officials or gov. employees,  to be looking out for you.

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The Internal Revenue Service has announced changes to the 2012 key amounts for Health Savings Accounts

(HSAs) and High Deductible Health Plans (HDHPs). HSA contribution limits and HDHP out-of-pocket

maximums will increase, while the HDHP minimum required deductibles will remain the same as 2011.

2012 Key Amounts

HSA Contribution Limit – Individual $3,100

HSA Contribution Limit – Family $6,250

HDHP Out-of-Pocket Maximums – Individual $6,050

HDHP Out-of-Pocket Maximums – Family $12,100

HDHP Minimum Deductibles – Individual Remains $1,200

HDHP Minimum Deductibles – Family Remains $2,400

Catch-Up Contribution Remains $1,000

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National Journal reported on the McKinsey and Co. study on how 30% of employer could drop group health benefits in 2014.

The study predicts that employers that understand some of th health insurance law could find savings in dropping coverage.  This all depends on how the each state sets up the exchange plan.

When you look at this study it shows that employers will drop that group health plan if the exchange plans make sense. There are industries that will have a very difficult time keeping employees on a companies health plan. When we look at the 9.5% rule.  If more the 9.5% of house hold income goes towards group health insurance premium then that employee can take the employer contribution and use that towards a policy through the exchange.  If an employee fall into this category why would they stay on the group health plan in the first place. They can go to the exchange with the employers money and be eligible for tax subsidies.

Right now there is a real fear that the health insurance exchange is going to be a high risk pool. This view is shared nation wide with all the exchanges.

Once the exchanges are developed then we will have a good idea what employers and employees will decide.

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Washington Post  Reported a large decrease in the PCIP health insurance program. HHS has funded the program with $5 billion dollars so that they can reduce premiums.

IBJ Reported that so far only 18,000 people have enrolled into the plan. HHS was expecting 375,000.

The reality is the premiums for any high risk pool are high. They are high because the program can not sustain the high claims.

For Indianapolis the premiums for the PCIP plans were already lower than the Indianapolis comprehensive health. So now with a premium reduction starting July 1st the new enrollment for the Comprehensive Health plan should stop. The only advantage now to the comprehensive plan is they will take anyone that has been declined. On the PCIP program you have to be without coverage for 6 months.

It will be interesting to see where the rates go to.

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Accountable care organization “refers to a group of providers and suppliers of services (e.g., hospitals, physicians, and others involved in patient care) that will work together to coordinate care for the patients they serve with Original Medicare (that is, those who are not in a Medicare Advantage private plan). The goal of an ACO is to deliver seamless, high quality care for Medicare beneficiaries.  The ACO would be a patient-centered organization where the patient and providers are true partners in care decisions.”  This is the ideal goal of ACO through HHS

The reality of these organizations is now becoming known through pilot programs that have been established. POLITICO

On May 12, 10 medical groups participating in a Medicare pilot program that paved the way for the ACO program declared that none would participate if the rule were not substantially modified. This is a huge blow to the ACO model. The providers that have participated in these programs have declared the risk of financial loss is to high.

This is very bad for health care reform because this program was the only staple of trying to control health care costs.

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Indianapolis has been awarded $6.8 Million from the Federal Government to Implement the key provision of the Affordable Health Care Act- Health Insurance Exchange.

And received a $1 million grant to look into setting up a state based exchange. So the $6.8 million must be an indicator that the DOI is going to move forward with a state based exchange.

HHS Factsheet

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The 4th circuit court of appeal heard oral arguments on the health care reform laws.

It has been reported that the Judges were leaning to uphold the law.

The challengers, the state of Virginia and Liberty University, have argued the decision to forgo insurance is not an economic activity that traditionally falls under Congress’ power to regulate interstate commerce. USA Today

Acting Solicitor General Neal Katyal argued no one truly abstains from the market for health care.

26 other states has challenged the insurance mandate in a separate case.

Most people have no clue what the long term effects of this law is going to have. This law is going to have a impact on every American.


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Indianapolis On Site Wellness

Inside Indianapolis Business reported on a story about a Dorel Juvenile Group attacking thier health care cost with an On Site wellness clinc. The company CEO stated that their health care costs were around $6 million a year. It sounds that this company has a Self Funded plan which requires them to pay the majority of the claims. This group decided that they would attack these claims but placing a FREE on site clinic to their employees.

We really don’t have a lot of details about how they set up this program but they did speak about a health risk assesment. From the health risk assement that must have given them more information on the health care needs of the employees.  Groups over 100 lives should look at having a health risk assement of the group to provide information on the needs of the group.

With balloning health care cost companies are looking to take aggressive action to control and reduce the cost of health care.

Dorel Juvenile Group has taken a very active role with improving the health care of their employee’s.  In today’s enviornment of a unhealthy work force company’s have to become involed with their employees over

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