Advantage Benefits

Issue: # 58

August 23, 2010

Dear

The only major carrier yet to settle with the Division of Insurance (DOI) is Fallon. As noted below all the other carriers have settled, but there is much confusion for groups that renewed from April to August. The new rate changes will be reflected in either the September or October billing cycles. The key point to note is that these businesses have benefited with the "temporary" 2009 rates for a few months with no retroactive adjustments!

In other words the increase was delayed, but the increase has finally arrived in the mail. If you are one of these businesses and want to look at some other plans, send us an e-mail.

As always, if you have any questions email Bill or Vanessa. We hope you find these newsletters are helpful, please forward to anyone who may find this of interest, by using the forward link at the bottom of this e-mail. To learn more about Worcester based Advantage Benefits, click here.

Sincerely,

Bill Randell CLU,CHFC, Vanessa Costa CLU,CHFC,

Advantage Benefits Group,

Robert Pozen Editorial

Two reforms that would make a difference

Great editorial in the Boston Globe by Robert Pozen, senior lecturer at the Harvard Business School detailing two changes that would truly bring down healthcare costs.

First, the Commonwealth of Massachusetts has the most mandated health benefits of any state. The Commonwealth furthers requires these mandated benefits to meet Minimum Credible Coverage (MCC), thus avoiding any state penalty. Infertility & chiropractic coverage are two state mandated benefits mentioned by Pozen that people should have an option to opt out of while still achieving MCC.

We would like to see plans be able to meet MCC without having prescription coverage. Why not take advantage of the buying power of the major chains, like Walmart.

Click here for the latest Walmart prescription list that allows you to buy a 30 day supply for $4 and a 90 day supply for $10 without needing any prescription coverage.

The second suggestion by Pozen was for the State Insurance Commissioner to establish a system of differential co-payments for patients based on the relative (actual) price of the services provided. Implementing a program like this may force individuals to think about which facility they are using. Why should an MRI that costs $500 more at one facility then another be the same co-payment for the subscriber? What impetus is there for the employee to be aware of these costs and try to control them?

This is exactly what Blue Cross is doing with their Tiered Network/Options Plans whereby there are different co-payments depending on what the underlying facility charges Blue Cross. Check their hospital tiering chart.