deductibles

Your Money Adviser: Trends to Watch for in Employer Health Plans

September 26, 2013 by NewsMaker

(Almost anyone can shop on the new exchanges, or marketplaces. But if your job comes with affordable coverage, you’re ineligible for any subsidies and you probably won’t need to shop there).

A few companies have made headlines with big changes to their employee health plans for next year. Walgreen, for instance, is shifting workers to a private health care exchange — separate from the state-based marketplaces created by the Affordable Care Act — where they can shop for plans with a contribution from the company.

And United Parcel Service recently told white-collar workers it would eliminate coverage for spouses who are were eligible for insurance through their own jobs.

So far companies making such major changes remain in the minority. But benefits experts caution that with so much in flux, it’s wise to carefully review the options your employer is offering for next year. “The overarching theme this year is that you have to pay attention,” said Jody Dietel, the chief compliance officer at the benefits management firm WageWorks.

Some trends to watch for include:

■ Higher costs for covering your spouse and children.

If you don’t already, you may pay a surcharge for covering your spouse if your spouse’s job offers coverage. Under the health reform law, companies that offer insurance to workers must also offer it to their children, but you may pay more for covering them, too.

■ Higher deductibles are here to stay.

The trend toward “consumer-driven” plans with high deductibles is continuing, as employers shift costs to workers. Usually, high-deductible plans are offered along with a health savings account, which employees can use to help pay for out-of-pocket medical costs. The idea is that if you are responsible for more of your medical spending, you’ll pay more attention to the cost. Most companies will now offer at least one such high-deductible plan as an option, and more are offering them as the sole plan. “Our best indication is that they’ll be fairly universally offered in the next few years, and in some cases, exclusively offered,” said Christopher Ryan, vice president of ADP’s Strategic Advisory Services, a benefits consultant.

■ Carrots and sticks to influence employee health behavior.

Companies are actively encouraging workers to improve their health, either by offering some sort of payment as an incentive for losing weight or exercising, or higher insurance premiums as a punishment. “Lots of companies are getting aggressive around wellness and health promotion,” said Tom Billet, a health care consultant at Towers Watson.

For instance, your employer may ask you to complete a personal health assessment, or undergo some sort of health screening, like a blood pressure or cholesterol test. As a reward, the company will deposit a bonus into your health savings account.

Here are some questions to consider this year:

■ Why did my employer gave me information about the state health insurance exchanges if I don’t need to use them?

The law requires employers to inform workers about the marketplaces. But for the “vast majority” of employees with workplace coverage, no action is warranted, Mr. Billet said.

■ Should I choose coverage under my employer’s plan, or the one offered by my spouse’s employer?

If you and your spouse have coverage available through your respective jobs, you’ll have to “do the math” both ways to see which option makes the most sense financially, said Helen Darling, president of the National Business Group on Health, which represents large employers.

You’ll also want to take into account any restrictions the plans impose. If your spouse’s plan is less expensive but your family’s doctor isn’t in the plan’s network, for instance, you might want to go with your employer’s plan, even if it costs more.

■ Is there any upside to high-deductible plans?

The plans usually are paired with a health savings account, which can be financed with pretax dollars by either you, your employer or both of you. You can use the money to pay for medical costs that fall under your deductible (and keep in mind that most preventive care is covered outside of the deductible, meaning you shouldn’t have to tap the account to pay for it). If you don’t spend the money, it can be rolled over to the next year.

E-mail: yourmoneyadviser@nytimes.com

Article source: http://www.nytimes.com/2013/09/26/your-money/trends-to-watch-for-in-employer-health-plans.html?partner=rss&emc=rss

Filed Under: Your Money Tagged With: deductibles, management firm, surcharge

You’re the Boss Blog: Small Business Health Insurance: Costs Still Going Up

September 15, 2012 by NewsMaker Leave a Comment

The Agenda

How small-business issues are shaping politics and policy.

The news for small businesses — not particularly surprising and not particularly good — in the Kaiser Family Foundation’s latest study of employer-sponsored health insurance is that the trend lines are unchanged. Costs continue to go up, and the number of companies offering insurance does not.

While across all employers, premiums for family coverage grew at the modest rate of 4 percent over the last year, small businesses faced an increase double that — the biggest annual increase in family plans since 2004. For individual coverage, small-company premiums increased 5 percent, which was also more than the increase in the broader market.

Some small-business owners have reported paying a larger share of employee insurance premiums as those costs have gone up, but that has barely registered on the Kaiser survey, which is conducted every year. This year, small companies (with fewer than 200 employees) paid 84 percent of premiums for individual coverage — more than large companies typically pay — and 35 percent for family coverage, a smaller share than at big companies.

But small employers are continuing to try to keep cost down in other ways. For example, they are still migrating to the cheapest plans. These are the high-deductible plans, often coupled with a savings arrangement, that are popular among conservative economists and policymakers. Increasingly, they are popular among small businesses, too. Since 2006, and especially since 2010, they have grown to cover nearly a quarter of all small-business employees, eclipsing every other kind of plan except so-called “preferred provider” coverage. (High-deductible plans are even more popular at large companies.) Deductibles are in fact rising for most employees — nearly half of covered employees at small companies in individual plans have a deductible above $1,000, and just over a quarter pay more than $2,000.

Despite all this, slightly more small companies — 61 percent — are offering health insurance this year, but that figure has been fairly stable since 2004. The small-business health care tax credit in the Affordable Care Act was meant to bolster that figure by inducing companies with the smallest and poorest-paid workforces to buy health insurance. (The credit is fully available to businesses with 10 or fewer employees with average wages below $25,000.) But it appears not to have moved the needle much. Health insurance coverage from companies with fewer than 10 employees suddenly spiked in 2010, for reasons that Kaiser couldn’t explain, but fell back in 2011 and holds steady in the latest survey. A similar bounce occurred among companies (of any size) with a preponderance of low-wage workers, but the subsequent decline was sharper — just 29 percent of those companies offer insurance now, a third fewer than did in 2008 and 2009.

Indeed, it may prove difficult to associate many of the findings in the Kaiser study with the Affordable Care Act. The changes made by the law that have already taken effect mostly took effect in 2010. In fact, Kaiser’s 2011 survey reported average premium increases between 8 and 9 percent over the 2010 coverage, the largest annual changes since 2005, although that study took care not to identify causes for them.

The big changes will come in 2014 (if the law isn’t repealed first). And there is one thing the new study tells us about those changes: more small businesses will be affected by them. In 2011, 72 percent of small companies offering insurance indicated that they had at least one health plan that was deemed “grandfathered” — that is, an existing plan that would not have to meet the law’s new standards. (Remember the promise the law’s advocates made that “if you like your plan, you can keep it”? This is what they were talking about.) This year, that share has fallen to 58 percent, and the proportion of small-company employees enrolled in a grandfathered plan has dropped, too, from 63 percent to 54 percent.

Article source: http://boss.blogs.nytimes.com/2012/09/15/small-business-health-insurance-costs-still-going-up/?partner=rss&emc=rss

Filed Under: Small Business Tagged With: compani, deductibles, employee insurance

Bucks Blog: Data Reveals Wide Variation in Dental Fees

October 13, 2011 by NewsMaker Leave a Comment

Consumers could save significant money on dental care by simply shopping around and asking about prices in their own communities, an analysis of health claims data shows.

Change: Healthcare, a company in Brentwood, Tenn., that helps employees of self-insured companies save money on medical care, based its analysis on more than 30,000 claims over 12 months from insurance carriers across the country.

The analysis found that the same routine dental exam for adults could cost as much as $240, or as low as $55, in the same geographic area (the review assessed cost variances within a 50-mile radius). Pediatric exams ranged from $180 to just $35.

An adult filling could cost as much as $360, or as little as $120.

In another, braces cost nearly $7,000 (including a previsit, braces application and follow-up visit), when another provider in the same community was charging $2,400.

The information is significant, said Howard McClure, chairman and chief executive of Change: Healthcare, because fewer than 60 percent of Americans have dental insurance, and even those who have coverage typically pay significant amounts out of pocket.

With more Americans now in so-called “consumer driven” plans with high deductibles, it makes sense to call around and, in essence, get several quotes. “People don’t understand there are variations in health care costs, and they’re sometimes wide,” he said.

Do you think it’s worth taking the time to call several dentists before making an appointment? And is cost your main criteria in choosing a dentist?

Article source: http://feeds.nytimes.com/click.phdo?i=3009591df5e04971db020314064772af

Filed Under: Your Money Tagged With: chief-executive, deductibles, dental fees

Bucks Blog: Tips for Negotiating the Cost of Medical Care

September 9, 2011 by NewsMaker Leave a Comment

Readers of Bucks know that we usually advocate negotiating discounts on all sorts of things, on the theory that it never hurts to ask. But what about medical care? Is there room to discuss the cost of, say, your annual checkup?

Consumer Reports thinks so. John Santa, an internist and director of the organization’s Health Ratings Center, said that haggling is a necessary option these days, as consumers pay more for health care through higher deductibles. (A hat tip to Kaiser Health News and NPR for alerting us to Dr. Santa’s column.)

Here are his suggestions:

1. Even when you’re healthy, tell your doctor that cost matters to you, and that you’d appreciate advice on saving money on generic drugs, etc.

2. If you get an unexpectedly large bill for an unplanned procedure, try to sit down with the doctor who ordered it and discuss why it was so costly. Check the bill for errors. Compare costs with average rates using a site like www.healthcarebluebook.com. And approach the provider about a possible discount or at least a payment plan. “Don’t assume the price on your bill is set in stone.”

3. For elective procedures — those that are planned, giving you time to do some research — ask for an itemized list of potential costs, in writing. While you should beware of too-good-to-be-true offers, it makes sense to shop around, he advised, “and bargain for what you think is a fair price.”

Have you ever tried to negotiate a medical bill? What was the result?

Article source: http://feeds.nytimes.com/click.phdo?i=db005e7d57739c792e11b7df9c128017

Filed Under: Your Money Tagged With: deductibles, doctor who, health news

Bucks Blog: Is Earthquake Insurance Worth the Cost?

September 8, 2011 by NewsMaker Leave a Comment

Jay Paul for The New York Times Dishes damaged in the earthquake centered in Mineral, Va., in August.

Like many homeowners, we pretty much ignored the option of earthquake coverage when we bought an insurance policy for our home. After all, we reasoned, it’s not like we live in California.

But last month’s earthquake based in Mineral, Va., which registered 5.8 on the Richter scale and was felt along the East Coast from Georgia to Canada, made us wonder if it’s worth paying for coverage.

A few thousand earthquakes occur each year in the United States, according to the Geological Survey’s National Earthquake Information Center. But the vast majority are low-magnitude quakes that don’t cause damage. (About 60 smaller earthquakes struck Arkansas, where I live, for instance, in February.) Coverage can be expensive if you live in a higher-risk area.

Like damage from floods, damage from earthquakes isn’t covered under a standard homeowner’s insurance policy, said Loretta Worters, vice president of the Insurance Information Institute.

To buy protection for your home and belongings, you typically must add an endorsement to your homeowner’s policy and pay an extra premium, which varies based on how close you live to known fault lines, the stability of the soils in your area and the type of home.

A wood-frame home in Washington State, for instance, might cost $1 to $3 per $1,000 worth of coverage, she said, while it may cost less than 50 cents per $1,000 on the East Coast.

Insuring a brick home, meanwhile (which is more vulnerable to damage from shaking), could cost from $3 to $15 per $1,000 in the Pacific Northwest, and 60 to 90 cents per $1,000 for coverage in New York.

Deductibles range from 2 percent of the replacement value of the structure to 20 percent, Ms. Worters said. Areas like Washington, Nevada and Utah, with higher than average risk, often have a 10 percent deductible. As with most types of insurance, you can often lower your premium by raising your deductible.

In California, an area of seismic activity, the average annual premium is $707, according to the California Earthquake Authority, which sells insurance to homeowners there. The coverage generally pays to repair or replace your home, subject to the deductible, but there are often exclusions, like for patios and detached garages. Just 12 percent of homeowners in California carry coverage, according to the earthquake authority, down from about 33 percent in 1996 — when the memory of the deadly Northridge earthquake in 1994 was still fresh.

Policies generally cover the structure of a house, its contents and additional living expenses in the event of an earthquake.

Have you considered buying earthquake coverage? What kind of a quote did you receive?

Article source: http://feeds.nytimes.com/click.phdo?i=94a94147ba5b3cb9c2d6e50558c4f460

Filed Under: Your Money Tagged With: deductibles, earthquake coverage, wood frame

Prescriptions: Health Insurers Keep Reporting Robust Profits

July 19, 2011 by NewsMaker Leave a Comment

UnitedHealth Group, one of the nation’s largest health insurers, reported its second-quarter results on Tuesday, and the good news for the industry looked as if it was likely to continue.

The company announced a double-digit increase in profits and raised its estimates for what it thought it would make for 2011, according to the company’s news release.

Once again, the high profits of the insurers appear to be partly the result of more budget-consciousness by their customers, even as the insurers ask for higher premiums. Many Americans seem to be putting off or forgoing medical care because of the weak economy and the increasing amount they are required to pay in medical bills as their deductibles and co-payments climb, as I wrote in a front-page article in May.

At the time, many health insurers insisted it was too soon to tell whether utilization would eventually rebound to the same levels as before the economic downturn. They argued that they could not count on the demand for medical care staying at relatively low levels.

Even now, UnitedHealth executives say they expect people to start using health services much more the way they did before the recession than they are currently. “We expect pressure on UnitedHealthcare’s gross margin percentage in the second half of 2011 and into 2012, due to increasing rate pressure from government customers and more overall normal utilization trends,” UnitedHealth’s chief executive, Stephen J. Hemsley, told analysts and investors.

Are the insurers right? Do you think once the economy rebounds people will be as quick to agree to a costly medical test or procedure? Will they start going to the doctor more? Or have high deductibles and co-payments changed the way people think about medical care?

Article source: http://feeds.nytimes.com/click.phdo?i=0acaba22154e2743432e1910e5349546

Filed Under: Business News Tagged With: deductibles, economic downturn, page article