| Issue: # 74 | December 12, 2011 |
 | | Happy 55th Birthday, click on picture |
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Greetings!
As we mentioned in our last newsletter, we see 2012 to be a more stable year for health insurance renewals. By stable, we mean in the high single digits. Hopefully this is the case for all our clients this year!
Something to watch this year? The health carriers are aggressively negotiating with many hospitals/providers and may even threaten not to renew contracts. In other words removing them from the network.
This recently happened with Blue Cross and Tufts Medical Center. Letters were sent to 88,000 Blue Cross subscribers announcing they would no longer be able to see that provider as of January 1st. In the end, a deal was signed and this was averted, Boston Globe story. Expect to see more of this going forward.
We hope you find these newsletters helpful, please forward to anyone who may find this of interest, by using the forward link at the bottom of this e-mail. Thank you for your referrals. To learn more about us, click here.
If you have a question or want a a quote, send us an email Bill or Vanessa.
Bill Randell CLU,CHFC, Vanessa Costa CLU,CHFC,
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Walmart
Health plan coming soon | |
For several years we have praised the benefits of the Walmart Prescription Generic Drug Program that cost $4 for a 30 day supply and $10 for a mail order 90 day supply. No health insurance card is needed, only a prescription from your doctor. We have been advising our clients to communicate this program to employees in an effort to save money.
This leads to the question then why does the Commonwealth of Massachusetts requires prescription coverage to meet MCC (Minimum Credible Coverage) to avoid a state income tax penalty? The removal of prescription coverage from health insurance coverage alone would save an estimated 10% of premiums.
Check out this story about Walmart, reported by the Huffington Post,. A 14 page document was leaked how Walmart was looking for a partner to develop a national, integrated, low cost health care platform. It only makes sense!
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Quest Diagnostics
Consumer Driven HealthCare!
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In the past most group sponsored plans were traditonal "co-payment" style plans. However, as premiums increase, employers have switched over to "deductible" plans.
With the exception of routine office visits and other preventive services, all other services are subject to the "deductible". You may hear the term "Consumer Driven Health Plans", basically this means a shifting of the responsibility to the consumer.
Employee confusion happens when during an office visit, disagnostic tests or MRI-PET-CAT scans are done. Under the traditional "co-payment" plan, these tests are covered for a defined co-payment price. These same services are covered under the deductible plan, but they are subject to the deductible, which basically means you pay the actual cost up to the deductible limit.
Here is a sample telephone call we frequently receive:
"I just went to the doctor because I was not feeling well and received a bill for $600 for the bloodwork!" First thing we do, ( like we did for Vanessa in our last newsletter sample case), is to determine if this was part of the annual routine check-up. If it was, it can be recoded and covered in full. If not, the deductible applies, which means you must pay. So what do you do?
When you are at the doctor's office and tests are requested, you need to ask questions. If you don't , your doctor, who may be affilaited with a higher cost hospital like UMASS, may send your bloodwork to UMASS. A month later you will get a bill from UMASS, although you never stepped foot in that hospital.
Again, this is the new meaning of Consumer Driven Healthcare. The burden is on the individual to learn more. A subscriber needs to understand they can have these tests done anywhere as long as it is a covered provider. Consumers must shop these servcies out and find the best price, like you would for any other consumer good. We recommend Quest all the time. They have locations everywhere with the most cost effective prices. |
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New Dental Plan
Coming Soon details will follow | |
We are putting the final touches on a new dental plan designed for small businesses. It will be reasonable priced and have preventive and basic benefits. There will be an option for major services like Crowns and Bridges, but no orthodontia. It can be completely employee paid and liberal participation requirments.
Many small businesses do not have dental plans and pay for these services with after tax, non deductible dollars. This plan will enable employees to pay for these same services through a payroll deduction with tax deductible dollars through the Section 125 plan. Not only does the employee save, but the company will save on the lower matching FICA obligation.
In addition there will be a $150 vision benefit for eyeglass wear. More details to follow, but the projected roll out is March 1st.
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Massachusetts rated top health care spender
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Massachusetts spent about $9,278 per resident on health care in 2009, according to a study in the journal Medicare and Medicaid Research Review, published by the federal Centers for Medicare and Medicaid Services.
There are other factors at work here, but one has to ask has Massachusetts Healthcare Reform has resulted in Massachusetts spending the most per resident on heath care in the country?
Full story, click here. |
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