Web Administrator, Author at Self Funded Health Insurance

April 3, 2014 by Web Administrator

PPACA clears way for small businesses who want to self-fund

New ACA laws will help businesses from 11-99 employees with self funded health insurance

Here is a really interesting article for employers with up to 100 employees seeking to self-insure their health benefits. In the past, employers who had too many claims and got in trouble of either:

1.) Running out of reserves

2.) Getting hammered at renewal by reinsurance “rate-ups”

3.) Lasering

Beginning in 2016, with the new ACA laws coming into effect for businesses, it more and more looks like groups in trouble will be able to return to a fully-insured plan (although they would still have to pay their “run-out” claims). Of course, these rates for fully-insured PPACA compliant insurance could be very high to the employer, employee, or both – We simply don’t know. But it’s good to know that there is an escape.

Download the .PDF for more or go to:

http://www.mydigitalrendition.com/publication/frame.php?i=202291&p=26&pn=&ver=flex

March 7, 2014 by Web Administrator

Self-funded health insurance and ACA-compliance

Self-funded health plans will become more popular under the new PPACA laws according to past President of the Society of Professional Benefits Administrators and others

Regulations, uncertainty, increased costs and constriction (meaning less choice in the market) will all cause more companies to consider and ultimately choose to self-insure in the future under the new Affordable Care Act health laws now in effect.

In fact, freedom from various state laws and the ability to customize health benefits for their employees as well as from additional taxes will help grow the self-insured reinsurance and TPA (third-party administrator) industry.

“Moving into 2014, there’s one more reason to move to self-funding,” said Mark Whiting, a principal with consultant Mercer L.L.C. in Kansas City, Mo. “PPACA may be enough to push a client that’s been teetering on the edge to move to self-funding.”

http://www.businessinsurance.com/article/20120219/NEWS05/302199999

http://www.spbatpa.org/node/2324

March 7, 2014 by Web Administrator

Who’s to blame for rising healthcare costs?

Are insurance companies to blame for health insurance being so expensive?

The costs associated with treating disease and healing the sick continue to rise. And new PPACA healthcare laws mean everyone is being charged more – For maternity care and other benefits they may not ever need (think seniors, men, children,…) or ever require. A new AP Poll says that 77% of people blame so-called Obamacare for their rising healthcare costs. But some are reporting that healthcare costs are skyrocketing due to the health insurance companies themselves. Middlemen, Administrators, File clerks, Transcriptionists, responding to more and more records and claims, than your aches and pains, all while doctors in many cases are being offered less per patient this year. As are hospitals.

“Because insurers are paid a fixed percentage of the claims they administer, they have no incentive to hold down costs.” So says Jeffrey Pfeffer for Bloomberg Businessweek (http://www.businessweek.com/articles/2013-04-10/the-reason-health-care-is-so-expensive-insurance-companies)

And while insurance carriers say that industry “profits” are not the reason costs keep going up, profits are not the same as a growing industry employing more and more workers that require to be paid, as well as require their own health benefits. Of course, private insurance companies also help detect fraud, encourage development of generic drugs, negotiate lower competitive pricing, instill wellness programs, and invest in medical information technology.

Aetna has felt the need to respond, by reporting their profits and inflation compared to other costs associated with healthcare as well as the industry as a whole. See their response here: http://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html

Internationally healthcare costs are also rising, especially in Singapore, Macau, Hong Kong, China, Taiwan, and Japan. And in poor, developing countries it’s rising even faster than in the West. (see http://economix.blogs.nytimes.com/2013/06/27/a-world-of-rising-health-care-costs/)

Whether you bypass the health insurance carriers by self-funding your own health plan for domestic and international workers; or choose group insurance with an international carrier and a broker that understands how to customize your benefits (as well as use other cost-saving techniques) to protect your staff, a good neighbor always helps. It’s our goal to do everything we can to help good people put good ideas to work overseas and see good results – To keep them safe. To use funds wisely. To see the job through to completion. We’re good so you can be better.

March 7, 2014 by Web Administrator

Self-insurance and the most common expensive medical claims

Do you know which illnesses are driving up health insurance costs?

Currently any form of cancer, incl.breast cancer (which equals about 4% of all insurance policyholders), premature babies, ongoing chronic conditions, heart attacks, strokes, dialysis, ventilators, diabetes, and treatment including drugs, therapies, tests, and more, quickly add up and equal 75% of U.S. medical costs.

Respiratory failure requiring a person to be on a ventilator is currently the most expensive treatment.
For the young and healthy, premature babies and extended hospital stays and bedrest create some of the highest charges.
And on average, maternity care now costs about $9,000 on average per baby.
Diabetes is a problem for 2-3% of all current health insurance plans insured, and equals about $10,000 per person, per year.

More for the Center for Disease Control here: http://www.cdc.gov/workplacehealthpromotion/businesscase/reasons/rising.html

How to address or anticipate these chronic cases if you are considering self-insuring your health plan? If you have staff assigned overseas or volunteering overseas or are on support? How much reserves do you need? There is no one set answer since each groups’ size and age and claim history will change the equation. That’s why experience is important. And why you need to work with experts that know the international market which is vastly different.