Anthem Blue Cross of California January 2011 Small Group Rate & Benefit Changes

January 2010 – 4.0%
April 2010 – 4.7%
July 2010 – 1.9%
October 2010 – 2.8%

Renewal Increases:  

The January through March renewal increases will vary greatly due to the rating changes Anthem Blue Cross has gone through in the past year. We have had a large variance by product and region, however, we are pleased to announce an average renewal increase for these three months of 14.5%.   

January 2011 Rate Change Overview:  

 

(These rates are for Small Group ONLY, the EmployeeElect 51-99 portfolio as well as the Small Group MHP compliant plans now have slightly different rates than our Small Group portfolio.) 

*These rate adjustments below are averages and will vary by plan and region 

EmployeeElect Total   Total – 4.7 %  

The PPO increases will be as follows

  • Premier Plans will receive an average increase of 3.5% 
  • PPO COPAY Plans will receive an average increase of 3.5%
  • Solution PPO Plans will receive an average increase of 4.4%
  • GenRx Plans will receive an average increase of 4.6%
  • Elements Hospital Plans will receive an average increase of 5.0%
  • EPO Plans will receive an average increase of 4.0%

The Lumenos HSA & HIA plan increases will be as follows

  • HSA 100% plans will receive an average increase of 8.5% 
  • HSA 80% plans will receive an average increase of 8%
  • HIA+ plans will receive an average increase of 8%

 The HMO increases will be as follows

  • All HMO plan families will receive an average increase of 3.5%

CA Employer Self Funding Wrap Guidelines 2-50 employees

Some employers have been told by agents to buy a high deductible health plan and to tell their employees that they have a lower deductible.  The employer then decides to reimburse the employee for a portion of any expenses incurred between the lower deductible and the high deductible health plan.  The insurance carriers price their high deductible plans assuming insureds will pay the cost under the deductible.  So when employers reimburse the employee by giving them a low deductible, the employee will tend to utilize more care than what the insurance company was expecting.  This is why carriers limit the plans that employers may self insure or “Wrap” underneath a high deductible health plan. 

Definition of a “Wrap Plan”

A “wrap plan” includes any employer-sponsored plan, which is:

(1) Paid for or funded in whole or in part by the employer and/or the employee;

(2) (a) provides reimbursement for health plan deductibles, copayments, coinsurance, or medical expenses, or (b) provides for the payment of set amounts in the event of hospitalization.

Examples include: an employer-funded flexible spending account (FSA), a health reimbursement account (HRA), self-funding of the deductible, an IRS Section 105 plan, a medical expense reimbursement plan (MERP), or a hospital confinement policy. As defined herein, a wrap plan does not include a health savings account (HSA) or employee-funded general purpose flexible spending account (FSA).

CARRIER “WRAP GUIDELINES 

Aetna

Only allows the following to be wrapped:

  • HMO Deductible plan
  • MC HRA 3000

For all other Aetna MC plans, including the HRA 5000 and the MC 10,000 plans, the only funding allowed is through Aetna’s HealthFund HRA. The maximum amount of the deductible the employer can contribute is 50%

NOTE: existing business currently funding through a qualified HRA other than Aetna HealthFund can continue to do so provided no plan changes are made. If plan changes are made, the HRA administration will need to transition to Aetna HealthFund HRA

Blue Shield

Only allows the following plans to be wrapped:

  • Shield Savings Plan 2250/4500
  • Shield Savings 1800/3600
  • Shield Spectrum 3000

No rules to how much of the deductible is funded 

HealthNet

Only allows the following plans to be wrapped:

  • HRA 3000
  • HRA 5000

No rules to how much of the deductible is funded  

UHC

Only allows the following plans to be wrapped:

  • Definity HRA 1500/80%
  • Definity HRA 2000/70%
  • Definity HRA 2500/80%
  • Definity HRA 3000/70%

May use United HealthCare or another HRA administration company

The maximum amount of the deductible the employer can contribute is 50% 

Sharp

No plans at this time are HRA compatible and/or allow HRA self fund wrapping

How to safely dispose of unwanted medications

If you read my post from 10-26, you may know that I spent my weekend snacking on pain pills due to a tooth abscess.  While scouring any medicine cabinet and drawer in my house (think of Ray Milland in “Lost Weekend”,  Jack Lemon in “Days of Wine and Roses” or Lindsay Lohan offscreen and you get the idea) for pain pills I found that my strong suit is NOT cleaning out cabinets.  Some of the expired or unwanted medications I had date back to 1991.  Now that I feel better I will be removing the old meds from my home.  Hey, I have new stuff anyway. 

What is the best way to get rid of old or unwanted medications?

It is not recommended that you either flush them down the toilet or down the sink drain.  Modern water treatment plants are not fully designed to deal with medication disposal. The long-term health risks posed by consumption of even minute quantities of these medications in drinking water and the full extent of environmental damage remains unknown. 

It is also not a good idea to throw them in the trash.  Safety experts strongly discourage throwing old medications into the trash where your children or pets can find them. Your trash will end up in a local landfill, where your medications could still have the potential to leach out.   Instead, many municipal or local trash services now have local household waste facilities where you can safely drop off your medications for incineration. Call your local trash service for options in your area.

There may be hazardous waste disposal facilities or drug recycling programs in your area.  Look online for this information. You could also contact your local pharmacy or physician’s office to see if they have disposal facilities available.

Is Dental Insurance All That Important?

Today I am writing to you through a pain pill induced haze.  Much better than the way I felt over the weekend, when tooth #30 finally gave out once again and decided to die in a very dramatic way – an abscess.  People say that a toothache is the kind of pain that “you wouldn’t wish on an enemy”.  I would.  But only if they were really, really bad. 

But I digress.  I used to think that the only benefit to dental insurance is the discounts provided by either the access to the PPO  network  or by the selection of an HMO dentist.  This still is true, the discounts are worthwhile.  I now know that the $50 or so dollars I spend each month for dental coverage is far less that the amount I would have to pay on the full charges for the dental care I am now in process of receiving.  Since I still have my wisdom teeth (pun intentional), I will illustrate how having dental insurance will save me money on the bridge now being made to replace the teeth pulled or ground down yesterday. 

Monthy Cost of Dental Insurance $50

Annual Cost of Dental Insurance $600

Maximum Annaul Benefit $1,500

Full Charge for Bridge $1,500

PPO Discounted Charge $1,200

50% Patient Responsiblity (my cost) $600

The amount I will have to pay for the bridge is the same amount I will pay for my dental coverage for this year.  If I didn’t have the coverage I would be reponsible for the full cost of the bridge, or $1,500.  Almost as painful as the abscess.

So to answer the question, yes I do think dental insurance is important.  I think people dont realize the sense of having either dental insurance or auto insurance – both are considered as useless until something goes wrong. 

Yes I am feeling better now.  I am grateful I have insurance – and the pain pills!

Health Savings Accounts – HSA Changes for 2011

No Change In Contribution Amounts from 2010   

What Is changing effective January 1, 2011?

  • Over-the-counter medicines and drugs will no longer be considered a qualified medical expense.
  • The penalty for using HSA funds for other than a qualified medical expense increases from 10% to 20%.
 

HSA Maximum Amounts

  2007 2008 2009 2010 2011
Minimum Deductible Amount
-Individual $1,100 $1,100 $1,150 $1,200 $1,200
-Family $2,200 $2,200 $2,300 $2,400 $2,400
Maximum Out-Of-Pocket Amount
-Individual $5,500 $5,600 $5,800 $5,950 $5,950
-Family $11,000 $11,200 $11,600 $11,900 $11,900
HSA Statutory Contribution Maximum
-Individual $2,850 $2,900 $3,000 $3,050 $3,050
-Family $5,650 $5,800 $5,950 $6,150 $6,150
           
Catch-Up Contributions (For individuals 55 or older until enrolled in Medicare)  $800  $900  $1,000  $1,000  $1,000