| Issue: # 84 | October 18, 2012 |
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Greetings!
2012 has yielded the best renewals in a very long time. Most of our clients have transitioned over to deductible plans and some have engaged in hospital tiering/limited network programs. As a result, there is more consumer awareness about pricing for services between hospitals, labwork and MRI/Imaging centers.
Despite the fact that renewals have stabilized, it is still important for groups to obtain quotes from other carriers to cover all the bases. Back in July we introduced a new program from Blue Cross called Healthy Actions. PLease take a moment to read the paragraph below that summarizes the program. We are working with our clients to help them successfully implement the plan.
If you have a question, send an email to Bill or Vanessa today.
Bill Randell CLU,CHFC,
Vanessa Costa CLU,CHFC,
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CDHP-Consumer Driven Health Plans producing results! | |
The term has been overused, but we may be starting to see some returns. In the past, traditional HMO plan designs removed any price sensitivity to the consumer. If a subscriber had an operation at UMASS versus St. Vincents/MedCity, it made no difference that the actual procedure cost less at one hospital versus another, since the co-payment was the same for both.
CHDP creates an incentive for the employee to use the lower cost hospital by offering a lower co-payment and/or deduction. At the same time, the health plan will save money when the employee opts for the hospital with the lower co-payment, thus lowering the cost of healthcare and therefore premiums.
What is also very interesting is that the HMO's have their own discretion on how to place each hospital into tiers. For example, the same hospital may be a low co-payment (preferred) hospital with Fallon but be a high co-payment (non-preferred) hospital with Blue Cross. Here is the tiering listing for Blue Cross.
It is not just hospitals that you need to be aware of. It is also services for Labwork and MRI-CAT-PET scans . It is important to find the best places (lowest costs) to get these services. Here is a listing from Blue Cross.
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Maximum hours | |
Recently a client asked what is the maximum amount of hours for benefit eligibility. The answer is 35 hours. Please note this link from the Commonwealth of Massachusetts.
If the employee is expected to work at least 35 hours a week on the average and will work for more than 12 consecutive weeks, the employee is considered to be full-time under the nondiscrimination requirements.
Change of pace Game 6 1975 World Series:
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Dependent to age 26 | |
Several years ago in Massachusetts a dependent under age 26 could only stay on the subscriber's health plan two years after they were no longer claimed as a dependent on their tax return. This is no longer the case.
Irregardless as to how the dependent files, he or she can stay a parent's health plan until they turn age 26. Good link.
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Blue Cross Healthy Actions
10 employees must be enrolled
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Healthy Actions is a new program launched by Blue Cross this summer. It is available as a rider and can be added to any of their plan designs. With any new program, we are typically cautious on recommending, but after reviewing and discussing with clients we are very comfortable with the process. Please note, you can only add this rider at renewal for existing cients with Blue Cross. It is available for groups from 10 to 50 employees. There is a very small cost, so we would analyze the cost differential to make sure it is feasible.
With Healthy Actions, employees have the opportunity to receive up to $300, in the form of a Visa debit card, when they 1) complete an online health risk assessment form and 2) ask their doctor to fill out a Clinician Health Review form. Even if they are not healthy, they receive $100 and an additional $200 if they meet the goals established by their physician.
Employer rewards are based on the percent of employees who complete the program by earning the full $300 reward.
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Percent of employees |
Employer's reward is... | |
20-49% |
1.25% of current year's premium | | 50-79% |
2.50% of current year's premium | |
80-100% |
5.00% of current year's premium |
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