Healthcare Update
2nd Qtr 2010 Rates 3rd Qtr 2010 Rates 
Once again, our focus is on small group (under 50 employees) health insurance rates. As of right now, there is no resolution with the Mass. Division of Insurance.
This means your renewal rates are not guaranteed, and in fact are calculated based on 2009 insurance formulas. Unfortunately, this problem is now effecting 3rd quarter rates as well. When will 2nd & 3rd quarter rates be approved? Could this turn into an election issue, whereby nobody wants to decide until after November? Lets hope not, but don't be surprised if final resolution is not till last quarter 2010.
Businesses renewing during 2nd and 3rd quarter will need to budget accordingly until the rates are approved. Based on the fact the four major HMO's carriers have lost $150 million in the first quarter, Boston Globe article, we don't see any of these carriers not billing retro-active. Be prepared, call us for help. Check out this editorial in the Wall Street Journal entitled Goodbye, Employer-Sponsored health plans. Also we have information below on a new Blue Cross plan that is now available. Could this be the future of health plans?
If you know anyone who may find this newsletter of interest, please forward and suggest they subscribe.
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| Blue Cross Options Plans - New!!
Is this the Wave of the Future ? Tiered Networks
| | Blue Cross has a new plan design available to both small & large group markets.
It is called a Tiered Network plan. What does that mean?
Basically, participating Hospitals are divided into 3 categories with 3 different benefit levels. The philosophy behind this is to educate the consumer that the cost of an operation or MRI can vary widely between hospitals.
Current plans have a set co-payment or deductible irregardless of where the procedure takes place. Two of your employees may have the same procedure and pay the same co-pay, but, your health plan may pay thousands more for the employee that utilizes the more expensive facility.
Hospitals that fall into the Enhanced Benefits Tier will pass on the lowest out of pocket cost to you. The middle category is the Standard Benefits Tier, and the last category called Basic Benefits Tier, passes on the highest out of pocket cost to you.
Some of these figures are amazing!
Example, if you elect to have an MRI at a hospital in the first tier / Enhanced Benefits, the average facility cost in the Boston region is $ 1,109. But, if you elect the same MRI at a hospital in the 3rd tier, Basic Benefits Tier, the average facility cost is $ 2,019.
This plan will be addressed in future newsletters to educate you on how it works. As you can see, it will be quite a challenge to explain and recommend to employees.
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| Federal Reform Changes Dependent Status
Thru Age 26
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Effective for all groups renewing after September 23, 2010, an employee will be able to keep dependents on their plan - Student or dependent status is no longer an issue. Also a dependent can stay on through age 26, prior it was through age 25. If you have questions, just let us know!
Blue Cross decided, effective June 1, 2010, to allow dependents, who are already insured on the plan, to stay on the plan up to age 26. All the major carriers have decided to do the same thing.
Here's an example: An employee has a 26 year old son who graduated 4 years ago from college. He has a full-time job, is eligible for benefits, and has not been a dependent on the tax return for 4 years. At renewal this employee could add the son to the family plan as a dependent. |
| BrokerSuite
Coming soon!
| The easiest part of our job is getting quotes. It is the extras, like this newsletter, HR feedback, and continued service/support, that separate us from our competition. We have just invested in a new service entitled BrokerSuite for our clients.
More information to follow as we get this up and running. 
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