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Category: Cosby Insurance Group

Nationwide Enrollment for Health Care Coverage Surged in December

Since the beginning of open enrollment, millions of Americans are gaining access to health coverage–many for the very first time—thanks to the Affordable Care Act. The most recent data indicate that more than 2.1 million people have enrolled in a private health insurance plan through the Federal and State-based Marketplaces since October 1.

Both states and the federal government have seen a surge in enrollment in December. Our HealthCare.gov enrollment nearly doubled in days before the January 1 coverage deadline compared to the first weeks of the month. Nationwide, including state and federal marketplaces, December enrollment so far is nearly 6 times that of October and November combined.

These numbers are expected to continue to grow through the end of March when open enrollment ends.

Read the full report here.

Health Law Seen as Obama’s Biggest Achievement, Failure

Findings highlight controversial nature of “Obamacare”

Americans see the 2010 Affordable Care Act as President Barack Obama’s greatest achievement to date as well as his biggest failure, underscoring the controversial nature of the law that is likely to define his legacy. On balance, more Americans name the healthcare law as his biggest failure (36%) than as his greatest achievement (22%).

Read the full report here.

How Employees Can Save Money on Health Care Costs

The Kaiser Family Foundation just announced the results of its 2013 annual health benefits survey, which provides a great snapshot of the trends in costs and coverage for employer-based insurance. You can use the foundation’s findings to save money on medical expenses now and to help you make smart decisions during open enrollment this fall, when you choose coverage for next year.

Moderately higher premiums. Premiums for employer-based health insurance rose by 4% from 2012 to 2013. Total annual premiums now average $16,351 for family coverage, with workers paying an average of $4,565 for their share of the cost. Premiums for individual coverage are averaging $5,884 annually, with employees paying $999 of the cost. Workers in small firms contribute a smaller share of the cost for single coverage than workers in larger firms do (16% versus 19%), but small-firm employees contribute a much higher percentage for family coverage (36% versus 26%).

The 4% increase is moderate by historical standards, but it comes on top of steady increases every year for the past 14 years. In 1999, the total cost for family coverage (both the employer’s and the employee’s share) was $5,791, and it was $2,196 for single coverage.

Cost-cutting strategy:  If both you and your spouse are employed and are offered health insurance coverage at work, figure first how much it would cost for each of you to stay on your own employer’s plan and include the kids on the less expensive plan. Then calculate how much it would cost to cover all of you on your employer’s plan or your spouse’s plan, if it’s an option (some employers are no longer providing coverage to spouses who can get insurance through their own employer). One employer may provide a good deal for individual coverage, but the other may be better for family coverage. And don’t look just at premiums — consider out-of-pocket costs and the extent of coverage, too.

Rising out-of-pocket costs. Premiums account for just a portion of health-coverage costs. Employers have also been boosting employee expenses over the past several years by raising deductibles and increasing employees’ share of the cost of care.

The average deductible is $1,135 in 2013, which is only slightly higher than in 2012 but a significant jump over the past several years (the average deductible was just $735 in 2008). The average co-payment for a primary care, in-network office visit runs $23, and the average co-pay for a specialty visit is $35. But many people now pay coinsurance, or a percentage of the cost of the visit rather than a fixed amount. Employees who pay coinsurance are expected to pick up an average of 18% of the costs of primary and specialty care, as well as an average of 18% for hospital admissions and outpatient surgery (see below).

More plans are offering several pricing tiers for prescription drugs — 81% of workers are in plans that have three or more tiers of cost-sharing. The average co-pay for first-tier drugs (usually generics) is $10; for second-tier drugs, $29; for third-tier drugs, $52; and for fourth-tier drugs, $80.

The average co-pay for a hospital admission is $278; the co-pay for outpatient surgery averages $140. But nearly two-thirds of plans have imposed coinsurance for outpatient procedures rather than a fixed co-payment. Some plans offer lower cost-sharing for certain kinds of care if you go to a retail clinic instead of the doctor’s office, and some pick up more of the bill if you use a doctor from a high-performance provider network rather than a standard in-network doctor.

Cost-cutting strategy: Choosing a higher deductible will generally reduce your premiums — and if your deductible is higher than $1,250 for individual coverage or $2,500 for family coverage, you may contribute pretax money to a health savings account that you can use tax-free in any year for medical expenses. Some employers even contribute extra money to their employees’ accounts. (As long as your policy has a high enough deductible to be HSA-eligible, you may contribute pretax or tax-deductible money to an account even if your employer doesn’t offer one.)

Now that more employers are switching over from fixed-dollar co-pays to coinsurance, you have more of an incentive to become a smart health care shopper. The lower the total cost for a procedure, doctor’s visit or medication, the less you’ll pay yourself. And with several payment tiers for drugs becoming the norm, it can be worthwhile to ask your doctor whether there is a generic substitute for your medication. Many insurer Web sites and employer intranet sites include tools to help you find lower-cost alternatives to your medications. See 30 Ways to Cut Health Care Costs for advice on saving money on medical and drug expenses.

Cash in on rewards for wellness. Employers continue to offer incentives to improve employee health, such as weight-loss programs, biometric screenings, gym membership discounts or on-site exercise facilities, smoking-cessation programs, lifestyle or behavioral coaching, classes in nutrition or healthy living, Web-based resources for healthy living, flu shots or vaccinations, employee assistance programs, and wellness newsletters. Some of these programs are more helpful than others, but a growing number of employers are offering financial incentives to participate, such as lower premiums, lower deductibles, a contribution to your health savings account, or gift cards or cash. For example, more than 55% of larger employers offer biometric screenings to measure workers’ health risks (such as cholesterol, blood pressure, stress and nutrition), and 11% of them reward or penalize workers financially based on specific outcomes.

Cost-cutting strategy: Find out whether your employer is offering financial incentives to participate in its wellness programs. You may discover that a program that was a hassle in the past is now worth your time — and the money can add up if you participate in several programs.

Future changes. The Kaiser Foundation survey shows the structure and costs of employer plans for 2013. Most employer plans aren’t expected to make major changes in 2014 because of the new health care law but are likely to continue with current trends. See The Health Law’s Impact on Employer Coverage for more information about how the health care law affects employer plans.

Read more at http://www.kiplinger.com/article/insurance/T027-C001-S003-save-money-on-health-care-costs.html?si=1#gK3tIhRjFA3lcsJV.99

Next Obamacare Crisis: Small-Business Costs?

Here’s why: Next year, small-business health plans — generally those that cover fewer than 100 workers — will have to comply with a wide range of new rules, particularly the ones that say employees can’t be charged more if they have health problems. Their premiums will vary based only on their age, whether they have individual or family coverage, what part of the country they live in, and whether they use tobacco — and older workers won’t be able to be charged more than three times as much as younger ones.

Those changes will be helpful to small businesses with older workers and employees with health problems, but they also mean that small firms with younger, healthier workers will have to pay more than they used to. The new small-business plans will also have to cover the same set of minimum benefits that individual health plans will have to provide, including pediatric care and mental health and substance abuse services.

“If you can’t use health [to set premiums] anymore, some people will move down and other people will move up,” said Gary Claxton, director of the Health Care Marketplace Project at the Kaiser Family Foundation. “If you’re a group of three 21-year-old men, you’ll pay more, because a group of three 64-year-olds somewhere else will be paying less.”

A lot of small businesses pushed off those changes this year by renewing their old, pre-Obamacare health plans early, extending them into next year. A common tactic, according to insurers and brokers, was to reset their plans with a Dec. 1 renewal date, which allowed them to hold onto the old benefits and rules as long as possible.

Next year, though, many of those small businesses will have to upgrade to health plans that comply with the new Obamacare rules. Unlike the canceled health insurance policies that largely hit this fall, those changes will be spread throughout the year.

But there will be a cluster of December renewals, industry officials say, and those small businesses will get the first look at their new premiums in October — right at the height of an election that’s increasingly being framed as a referendum on the impact of Obamacare.

Read the full report here.