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Issue: # 117
| <September 24, 2014 |
 | | Ryder Cup 2014 |
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Dear :
The Group Health insurance marketplace has completely transformed since we first started
 | | Robin WIlliams on GolfCaution: strong language |
offering plans in 1990. At that time, each carrier had 2 or 3 plans available with co-payment options only. Renewals were stable, almost always single digit, with decreases on occasion.
Today, these same carriers have over twenty different plans with all sorts of fancy names. These plans range from co-payments options to a variety of deductible options, and now over the last 3 years we see Tiered Networks, Limited Networks and H S A Options. In some cases, the deductible you pay is dependent upon which hospital/provider you use.
To be quite honest, we get confused and have to double check plan designs specifications daily - and we do this every day. By the same token, we expect people who have no insurance background to go onto the Connector website and figure out which plan is best for them? Connector Authority can spend 4.3 million on PR firm to reach out to people about the plans, but it still does not help them to understand what they are looking at?
Every day we work with companies and realize more and more, anyone can give you a rate. Rates are step 1 in a long process of what works for your company. Our expertise is that we examine every possible angle to make sure you have the lowest possible rates for the plan designs chosen. We "work" the census to make sure any new hires or terms have been accounted for at renewal. WE look at any possible "seniors" who may need to look at medicare options. When we are presented with an unmanageable renewal, we propose alternate plan designs that add the latest options for cost control measures. This can mean introducing deductibles, limited networks and surcharge plans. It can mean looking at the employer contribution and making adjustments there. Plenty of time is devoted to making sure your renewal has been given the highest scrutiny!
If you are reading this and are not a client - ask us for testimonials. WE are proud to say that most of our clients have been with us for a minimum of 10 years. They are just like you - family owned, and hard working every day and night to provide the best possible options for their employees. They want this process simplified but with as much attention to detail as possible.
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Costs of the Connector Authority exceed 1 billion?
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The Pioneer Institute did a study and the costs exceed 1 billion, click here for a link to the blog. Here is a small portion:
The cost of transitioning to an Affordable Care Act compliant health insurance exchange is likely to top $1 billion over two years, far more than it would have cost had Massachusetts simply used the federal government's healthcare.gov exchange, according to a new Policy Brief published by Pioneer Institute.
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ReadyMED
Obviously if it is an emergency then go to the emergency room, but what if it is not an emergency?
Emergency rooms are expensive, usually require long waits and most importantly not always your only choice. Check out ReadyMED that has locations in Shrewsbury and Auburn and lists the wait time at both offices at the top of their site. Your plan will cover services as they would any visit to a specialist, versus as an emergency, which will save you money.
There are more facilities then just ReadyMED that can help you and you should call the 800 number on your ID card for a facility that is closest to your location to save yourself time and money.
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Updates from Harvard Pilgrim and Blue Cross
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Harvard Pilgrim will be making changes to its Prescription Drug Formulary beginning January 1, 2015. If you are an existing Harvard customer, these changes will take place upon renewal in 2015. One of the major areas driving the escalation of health care costs is pharmacy. In order to ensure coverage remains affordable, Harvard will now have 4 and 5 tier pharmacy options. The new "Value Formulary" ensures coverage for virtually all drug classes. Certain drugs, specifically multi-source brands, for which there are more affordable alternatives available , will be excluded. Also certain higher cost drugs are being moved to the highest tiers. Their hope is a more cost-effective offering. For groups of over 50 employees, you will have a choice to retain the current Prescription format or opt for the new one.
We have been told that this new format for prescriptions for the small group marketplace will result in "Aggressive Pricing" come January 1st! Stay tuned, we will be quoting these new plans!
Blue Cross is coming out very strong with their newly revamped Dental Plans and their brand new Vision Plan. In many cases you can materially lower your dental costs and add a vision plan for less than current Delta dental premiums. This is for the small group, under 50, marketplace.
Please remember that all premiums for both Dental and Vision are available on a Pre-Tax basis. SO, as an employer you could theoretically add these benefits on a 100% Employee Paid basis, and then actually generate a slight savings in FICA Payroll Taxes, as a result of the new deductions!
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In 2016, ACA covers employers with 50 or more
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Are you ready? We are finding that there are alot of companies that have alot of part-time employees; for example, restaurants. They may have 80-100 part-time employees but think that this many not apply.
They could be right but they will need to prove that this is less then 50 full-time equivalents. How are they going to do that?? We can show you how!!
Send us an e-mail.
Did you know the first Ryder Cup in 1927 was at Worcester Country Club?
 | | 1927 Ryder Cup Team |
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According to a report released by the Massachusetts Center for Health Information and Analysis on Tuesday, health care expenditures in Massachusetts in 2013 totaled $50.5 billion, or $7,550 per capita. Health care spending in Massachusetts increased by 2.3 percent per resident from 2012 to 2013, growing at a rate faster than the 1.5 percent rate of inflation.
 Massachusetts Wellness Credit- take a closer Look We are still talking to employers about the Mass. Wellness Credit which was first announced for calendar year 2013. Don't forget to check this out, or send us an email for details. Employers, especially manufacturers, are currently spending money on safety measures in the office and shop. WE can show you how to convert the deductible expense to a Mass. tax credit. Advantage Benefits would like to thank Drs. Brian Thamel and Valarie Ricciardi, owners of Family Eye Center/ Vision Source of Worcester & Spencer. Recently they participated in one of our wellness fairs in Worcester Mass. There are so many offerings and activities to also support your local business owners at these Wellness Fairs - everybody wins. One of our clients recently added a new Blue Cross Vision Plan. Family Eye Center talked to employees, reviewed the types of services available, and offer customized service. That's Local Family Owned Service!!! 
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