What to Expect for 2018 Premium Increases

What to Expect for 2018 Premium Increases

UBS released its 2018 Large Employer Health Benefits Survey and the results are encouraging. Premium equivalents for this largely self-insured study group are expected to rise 6.1% on average from 2017. Interestingly, the shift to high-deductible plans and the increase in non-premium cost-sharing are expected to stabilize. Makes sense – the economy is improving and employees are… [Read More]

Zombie Apocalypse: Health Insurer’s Tax

Zombie Apocalypse Health Insurers Tax

In 2014, fully-insured employer plans were greeted with a nasty surprise – the Health Insurance Providers Fee. The insured’s already massive healthcare costs were being further inflated 1.5–2% due to the new tax congress levied on insurers, which was based upon each carrier’s market share in the health insurance market. Of course that $8 billion… [Read More]

Take Advantage of Health Insurer Cherry Picking

Take Advantage of Health Insurer Cherry Picking

I frequently witness the frustration of small group employers over the inability to customize plan design or receive premiums that reflect the health of their employee population. Growing companies often look forward to hiring their 51st employee, the magical threshold where many state insurance laws allow rate negotiation and some plan design flexibility. Some states even… [Read More]

Stop Loss Insurance… More Important Than Ever

Stop Loss Insurance... More Important Than Ever

With the increase in popularity of self-insurance, health plan sponsors must take the time to fully understand the “safety net” that is typically purchased alongside these plans to protect them from unexpected costs. There are two elements of stop loss: Individual (or Specific) Stop Loss (ISL) protects against the costs of any one claimant exceeding… [Read More]

Good News – the Stop Loss Market Is Vibrant

Good News – the Stop Loss Market Is Vibrant

Uncertainty and frustration abound in the healthcare market today, especially with all of the brewing legislative changes and tension over the market’s response. On the employer-sponsored plan side of things the challenge to improve affordability goes on as well – but you can only make so many plan design changes to keep up. High deductible… [Read More]

Cost-Control Over Risk: More Employers Embrace Self-Insurance

cost-control-over-risk

More and more employers are embracing self-insurance; according to the U.S. Department of Health & Human Services, more than 80% of companies with 500 or more employees have self-insured plans. That’s astounding in the context of historic statistics which showed that only the largest employers used this funding mechanism. And since new products from traditional… [Read More]

A Look at Catastrophic Claims in the World of Stop Loss

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Sun Life Financial recently released a report on the top ten claims conditions which give rise to stop loss claims under a self-insured healthcare plan. Sun Life analyzed four years of their catastrophic claims data and found that these ten claims represent 53% of all stop loss claims reimbursements. 26.6% of all stop loss claims… [Read More]

Self-Insurance: And You Didn’t Even Know There Was a Problem

Self-Insurance

One of the advantages of self-insurance is the avoidance of state insurance regulations. Federal law provides that with certain exceptions, ERISA preempts “any and all state laws insofar as they relate to any employee benefit plan.” Many employers manage employees in multiple states, and even if their employees are in a single state, adopting a… [Read More]

Moving Forward Amidst Continuous Change and Consolidation

Maze

The most recent news in healthcare consolidation is certainly the insurer mergers: Anthem’s purchase of Cigna and Aetna’s of Humana. Consolidation has ramped into high gear throughout the healthcare industry – and it means we are in store for continuous change. Since I started in this business, I have watched the market shrink from in… [Read More]

Health Insurer Merger Mania

Health Insurer Merger Mania

It’s official – Anthem, the Blue Cross franchise aggregator, will be acquiring Cigna for $54 billion, which would make them the largest health insurer. Earlier this month, Aetna Inc. agreed to buy Humana Inc. for $37 billion, and Centene Corp. announced it would acquire Health Net Inc. for $6.3 billion. My father used to say,… [Read More]