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Issue: # 127
September 24, 2015
  
 

Dear  :     

 


We have been working on 4th Quarter Insurance Rates and so far it has been a challenge.   Perhaps the most troublesome item is the new 4 tier rating system now mandated by ACA for groups less than 50 employees.  The issue is that historically you would announce a rate increase to employees and the increase was uniform, regardless of the type of coverage.
 
Now, the new rating methodology creates disparity, with the brunt of the burden placed on those families that are defined as "full families", meaning employee, spouse and children.
For example, you may have a group that has a 7% increase for singles, an 18% increase for families, but then you will have an Employer with Spouse only, or Employee with Children  that will see a rate decrease from last year.
 
As always, we examine pricing from all carriers as well as limited networks, tiered networks, and deductibles plans to come up with a solution that works for both employer and employee.
 
Expect more of the same for 2016, and for our larger groups 100 and up, make sure you have addressed all the compliance and reporting issues you will be responsible for in 2016.
 
As always, we need your feedback.  Share you thoughts, concerns or issues to us now. 

Thanks

The Hanover Theatre - Downtown Worcester

Our last newsletter announced our relationship with The Hanover Theatre in Worcester.
Our clients will be able to reserve tickets to upcoming shows at a group discount. As the Holiday Season approaches, tickets also make a great gift, or special event to take the grandchildren, or just a night out for the adults.  Here are a few shows you may like:
 
A Christmas Carol:
Saturday, December 19th at 7:00 PM
Sunday, December 20th at 1 PM
Great Seats in the Orchestra A-M and Loge
Discounted Pricing $48 for adults and $ 25.50 for children and students
 
Last year's promotional video
   
Holiday Boston Pops
Friday, December 4th at 8PM
 
Seats in Rear Orchestra and Lower balcony
Discounted Pricing $ 86.80 for adults
 
Place your order now before the holiday season gets  underway.
Tickets make great bonus gifts nad raffle prizes to employees,  friends and family. 
 
Tele Health Network

We are always looking for ways to save our clients money.  Recently, we read an article  about many larger employers using Tele Health to fight rising medical costs and claims. 

After further research we found that this is a stand alone option available to both large and small business employers.  Basically it is a supplement to your existing medical plan. 

 

This plan allows Direct and Unlimited Access to Doctors 24 hours a day, 7 days a week via phone, email or video.  Typically they provide treatment by phone for common conditions such as allergies, sore throat, infections and more.  The platform is that over 70% of all ER, Urgent Care, and  Doctor Office Visits  can be safely and effectively handled over the telephone.  The doctors can prescribe medication and there is NO charge for the consult fee.  There is a discount card for prescriptions. which you can compare to your current co-pay from existing medical plan.

 

There are also mobile apps available to find pharmacies, doctors, pricing comparisons for RX and, if it is synced to your existing medical plan, it can track deductibles as well.

 

So, why is this something we all should take a closer look at:

 

* Increased employee productivity

* Fewer Sick Days taken

* Employees Address health and wellness issue on their own schedule

 

 

For larger employers that are either self funded, or fully insured with pricing determined partially be claims experience, this can effect your bottom line.  If employees are using  this service and not going to the ER, urgent care, or doctor visit, then reducing claims means reducing premiums.   This has the potential for a measurable reduction in healthcare costs.

 

If you are a small business with less than 50 employees, odds are you have a deductible plan in place.   This plan could mean employees can bypass doctor visits and save money.

Regardless of your size, this can result in more efficiencies and employees can handle these medial issues in the privacy of their home with this direct access to physicians. 

 

We are learning more and more about this and will keep you posted.

Sound interesting?  Send us your questions so we can give you more info.

 

 

 

Advantage Benefits Group, Inc.

As many of you know, after working at a large insurance agency in Worcester for 5 years, we officially started Advantage Benefits Group in 1992.  The focus has always been on group medical, dental, life and disability. 
 
 
The industry has changed significantly since then.  In the late 80's and early 90's there were more carriers, but less plan design types.   Renewal increases were only single digits, and s decreases were not that uncommon.  HMO's merited more scrutiny as doctors did not always participate with certain carriers.
 
Today there are still only a few carriers, however, the plan design options are
overwhelming.  Pricing is outrageous and for groups with less than 50 employees there is  flexibility, loyalty discount, multiple year guarantees, or any accommodation for your business.  For larger employers we have seen the rising costs of healthcare continue for procedures and screenings including MRI's, outpatient surgery, prescriptions and inpatient care.
 
The broker marketplace has changed too.  Today everybody wants to "sell" health insurance.  One Stop Shopping is what we see from payroll companies and property and casualty agencies.  Mergers and acquisitions are on the rise as well as the larger consulting
firms want to add small businesses to their portfolio.

Our office still continues to focus on the core benefits employers need to remain competitive, retain employees and attract talented new hires.  The marketplace for health insurance has become more complex so technical expertise has become more important.  But, the primary way for us  to distinguish ourselves from other firms is with our service levels.

ON line administration
COBRA assistance
HR guidance
Mass sick Pay are areas that we regularly assist.  
Mass Wellness Credit


Running insurance quotes is the easiest part of our job.  Bringing new ideas to the table and staying one step ahead is at the top of our agenda. Thank you for your business.  Our average client has been with us for over 12 years and we truly enjoy working with our business owners.

As always, please do not hesitate to call with any questions or concerns. thank you for your referrals and testimonials as well.
 

1)   Does the Massachusetts Sick Pay Law apply to part-timers? 
Yes it does.

2)   I really do not like this new four tiered rating system from the carriers can they please give me a two tiered rate?   
No you can not.


RIP Yogi, love this commercial with Jason Alexander from 1987