by Admin. | Aug 18, 2022 | group health insurance, Health Care Reform, healthcare, Individual Exchanges, NY News, Small Business Group Health, United Healthcare
Yesterday, NYS Dept of Financial Services approved 2023 health insurance rate requests yesterday. Small group rates increased by 7.9% and 9.7% for individuals.
As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers see original –2023 NY Small Group Carrier Rate Filings. Despite only 3 months of mature claims data experience for 2022 health insurers’ original requests were noticeably above the average of 16.5%/individuals and 19% for small groups. For example, regulators last year approved average rate increases of 3.7% for individuals and 7.6% for small group plans. Over 1.1 million New Yorkers are enrolled in individual and small group plans impacted by the rate increases, the state agency noted.
The recent COVID-19 surge irony reflected a lower cost utilization due to COVID-19. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% in recent years years. That said, in an anticipation of spikes in claims submissions + overall inflation, a larger than average increase is needed. This is in addition to increases in pricing by hospitals, consolidated IPA groups, and pharmaceuticals.
The state noted that the premiums increase main drivers are medications. “Rising medical costs and inflation continue to put upward pressure on premiums,” said Superintendent Harris. “With our rate actions announced today, we continue to prioritize the financial wellbeing of consumers while ensuring that New Yorkers have access to a robust, stable health insurance market.” Also, DFS, recognizing the continued uncertainty of the pandemic’s effect on consumers’ health care costs and the economy, held insurers’ profit provisions to a historically low 0.5%.
Oxford/Unitedhealthcare, notably, got only a 6% rate increase approval for next year. This is a sharp reduction from the original 16.8% request in part by disagreed anticipated costs, held reserves, overall market pricing, and reinsurance gained from ACA’s Risk Corridor. See more info here, https://www.medicalsolutionscorp.com/risk-adjustment-reinsurance-and-risk-corridors/.
Small Group Market
Almost 850,000 New Yorkers are enrolled in small group plans, which cover employers with up to 100 employees. Insurers requested an average rate increase of 16.5% in the small group market, which DFS cut by 52% to 7.9% for 2023, saving small businesses $632.4 million. A number of small businesses also will be eligible for tax credits that may lower those premium costs even further, such as the Small Business Health Care Tax Credit.
DFS SMALL GROUP MARKET RATE ACTIONS
*Indicates the Company will offer products on NY State of Health Marketplace in 2023.
PEO Alternatives to Small Group
Before you consider renewing automatically, you should first find out what is a PEO so that you can know exactly what to expect from it. PEO’s are large-group markets underwritten. With the right PEO, you will be able to manage your business’s demand for growth and your employees as well.
Clients on average save 15-40% off the small group market. If you are looking for a complete insurance solution for your business, go to our website and check out our business insurance solutions. Contact us for more information today.
Learn how a PEO can make a difference for your group. For more information on how Employer-Sponsored Insurance and a PEO can make difference for your small business please contact us at firstname.lastname@example.org or 855-667-4621.
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by Admin. | Jun 17, 2020 | Health Exchanges, healthcare, HR, Technology
Moving to Paperless Benefits Admin System
As COVID-19 has challenged the status quo and disrupted the way we’ve always done things. Working from home have ushered in a new reality for benefits, and one of the more tangible questions right now is: “We’ve always held an in-person benefits fair, so what should we do now?” And the answer: “Let’s just move the benefits fair online.”
Things To Consider Before You Open
1.What’s Your Strategy for Going Paperless?
The best recommendation for most offices is to switch to paperless going forward. Decide how you’re going to organize your electronic files (tip: making it match your paper filing will make the transition easiest on your staff). Then put a scanning policy in place and stick to it … going forward. Baby steps! Once your staff has gotten comfortable with the new system, they can feel free to pull in old material as it’s needed.
2. Replace paper forms with digital ones
US companies spend more than $120 billion a year printing paper forms alone. That’s a staggering, unnecessary amount of money that can be saved by using online forms instead. With online forms, you’ll also see faster response times, with the submission data stored neatly in the cloud
Automated processes reportedly make far fewer errors than those performed by humans. All data errors should be corrected when discovered for recordkeeping compliance purposes. But documents with errors in paper-generating systems must be corrected and re-printed.
A key benefits of taking your HR paperless is simply the fact that you will be reducing overall waste while saving time and money. Paper reams may not be the most expensive commodity your business is using, but it may be the most easily upgraded. With our partnerships we are able to deploy a basic online beneeifts admin ssytem at no cost to our clients
Employers do not spend as much time on insurance forms. In fact, for a group of 50 employees, employers decrease the time they spend on forms by 84%. This is because we map employee information directly to carrier forms and is rules-based, which validates data entered to avoid incorrect and missing information. This means that when an employee completes an insurance form, plenty of their information is auto-populated and fields cannot be left incomplete. If a signature is required, the employee can e-sign forms in Ease using their mouse or finger. Additionally, all data can be securely stored online
6. Recruiting Millenials
You can enable new employees to enroll in benefits online. They can see the cost per pay period for each plan they are eligible for, as well as view side-by-side comparisons, informational videos, and digital brochures about plans they are considering. Additionally, they can log into our portal from anywhere, at any time, and view a detailed benefits summary. An iOS and Android mobile app allows employees to quickly access plan information, details, and policy numbers from any location.
Employers can use Ease to initiate pre-boarding activities the second an offer is made. Through the Offer Letter feature, employers can send applicants offer letters with custom details like salary, company policies, start date, and eligible benefits. This enables applicants to view all of the components of their offer in one go. If they do accept, the employer can prompt them to begin onboarding and benefits enrollment right away.
7. Mid-Year and Annual Renewal Changes
How many times have come accross Clinets who simply dont want to be bothered with changes. On Average 12% of costs are attributed to inertia. With our paperless benefts system SMB can easily add and manage voluntary coverage. Employers can work to choose which voluntary benefits are best suited for their employees and their benefit offering, and employees can enroll in these plans at the same time as their medical plans. They’ll even see the cost per pay period per voluntary plan and, in many cases, instantly view their eligibility.
Each employee has a real-time historical record. Any qualifying life event, like a divorce or a new dependent, can be made in their real-time historical record. The employee or employer can make this change and deployed to the insurance carrier.
8. Payroll integrations
Several integrated payroll companies charge $20-$50 per employee per month dependizng n the size of the SMB. Ease enables employers to easily keep track of payroll deductions with its Consolidated Billing report. This report calculates and populates new employee payroll deductions into payroll. Employers can export the report as an excel file and upload it to their payroll provider.
Additionally, with different payroll etablished exchnage connections that makes it easy to:
- Add new employees in one system, either the payroll provider.
- Process benefit changes, since changes flow from the payroll provide or vice versa.
- Keep employee records up to date with automated data syncs.
9. Tracking Employees’ Time-Off & Performance
Ease’s suite of HR tools, EaseHR, was built to help employers manage growth. The software uses the same login and employee information from benefits enrollment, making setup simpler. The different tools included in HRIS by Ease are:
- PTO Policies: Employers can set up holidays and manage custom PTO policies. Employees can view hours remaining per policy, such as PTO, sick leave, and FMLA.
- Time-Off Tracking: Employees can request time-off and managers can approve those requests on the go.
- Metrics: Visualized HR stats including employee growth, company diversity, and organization charts.
- Employee Events & Company Directory: Employees can connect at any time with a repository of employee contact information. Managers can keep track of birthdays and work anniversaries.
- Ease iOS and Android Mobile App: Access all time-off tracking features and your company directory from anywhere at any time.
10. Hassle of Switching
With most leading paperless payroll and Thrid Party HR and COBRA providers already integrated this becomes more organic. You are not alone. We help with group set-up and deployment. The Client serves as a QB but are not required to become the power-user of the system. Each employee has a unique login, allowing them to enroll in benefits themselves. They can reach out to the employer if they have questions, but also have the ability to explore the software themselves.
Goodbye Paper, Hello Ease Simplified Benefits and HR– Click Above
EASE Ben Admin EmployerOverviewOne-Pager_16SEP19_V2-AM
Why a Private Exchange?
Private Exchange Made Simple
Your employees shop online for everything else, why not benefits?
Each year, Ease surveys tens of thousands of employees who chose benefits through our online benefits marketplaces to find out what they think of the experience. Overwhelmingly, the data point to employees being more satisfied with their experience overall, compared to traditional benefits offerings:
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The information provided on this website is intended for informational purposes only. Millennium Medical Solutions Corp. does not offer legal or medical guidance. Those with legal or medical questions should seek appropriate assistance from a licensed professional. Stay up to date by signing up for Newsletter and Coronavirus Dashboard below. Please connect for a one-on-one-demo at email@example.com or 855-667-4621
Learn how our PEO Partnership can help your group please contact us at firstname.lastname@example.org or (855)667-4621.
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by Admin. | May 31, 2019 | healthcare, Individual Exchanges, NY News, Small Business Group Health
The NYS 2020 Rate Requests filings were released today. The total weighted average increases were a modest 8.4% for Individual Market and 12.0% Small Group Market. Final rate approval expected early August. The past reductions averaged 10-50%.
The lower requests reflect a stabilizing ACA market. Insurers’ financial performance improved nationwide last year to its highest level since the passage of the law. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% last year in the individual market nationwide. That led to plans paying $800 million in rebates for failing to meet requirements on medical spending, according to the Kaiser Family Foundation.
This early filing request deadline request requirement is not an Obamacare requirement. As per NY State Law carriers are required to send out notices of rate increase filings to groups and subscribers.These are simply requests and the state’s Department of Financial Services has authority to modify the final rates. But they are the first indication of what New Yorkers can expect when shopping for health insurance on the individual marketplace at the end of this year.
By contrast last year’s NYS 2019 Rate Request early filing request were higher at 7.5% small group and an astounding 24% for individuals. The NYS final August 2020 rate approval are expected to be lower. For example, the final filing rates were approved NYS 2019 Final Rates Approved at a modest 3.8% small group and 8.6% for individuals. Using these past figures one projects a 2019 Final Rates of 5% small groups and 8% individuals.
A spokeswoman for the state Health Plan Association said insurers have worked to control costs, which have been driven up by rising prescription drug prices and state mandates that require coverage of certain services.
“Our member health plans have been committed to making health care more affordable, working hard to rein in rising health care costs and contain their own costs,” she said. “The proposed premium rate requests are reasonable, reflecting the cost of care.”
In the small-group market, insurers asked for a weighted average 12% boost in 2020 after they were granted a 3.8% bump for this year. UnitedHealthcare’s Oxford, which controls more than half of the small-group market, asked for a 15.9% increase, which was the highest among all plans. Oscar, at 15.8%, was close behind. Notably, Healthfirst has requested a 5% reduction.
Defined Contribution Choice: Instead, the correct approach for a small business in keeping with simplicity is a defined contribution model using a Private Exchange. This is a true defined contribution empowering employees with the choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll. Both employee and employers still gain tax advantage benefits under the business. Also, the benefits, rates and network size are superior under a group plan as THE RISK OUTLINED ABOVE ARE HIGHER FOR INDIVIDUAL MARKETS THAN SMALL GROUP PLANS.
To be clear: These trends affect a small subset of the insurance market—non-group plans that cover less than 2 percent of the population. Many qualify for tax credits that lower their net costs and reduce or eliminate the impact of year-to-year rate increases.However, non-group customers with incomes above 400% of the poverty level ($48,560 for a single adult) get no subsidy—and feel the full brunt of any hikes.
- You may view the NYS 2019 Rate Requests DFS press release, which includes a recap of the increases requested and approved by clicking here.
- For a custom analysis detailing YOUR upcoming 2019-2020 renewal please contact our team at Millennium Medical Solutions Corp (855)667-4621. We work in coordination with Navigators to assist with Medicaid, CHIP Child Health Plus, Family Health Plus and Medicare Dual Eligibles. We have Spanish, Russian, and Hebrew speakers available. Quotes can also be viewed on our site.
- See Health Reform Resource
*These averages may change based on DFS’s review of the rate applications.** Empire submitted a filing that DFS is evaluating.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us at email@example.com or (855)667-4621.
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by Admin. | Aug 6, 2018 | CT, group health insurance, Health Exchanges, healthcare, latest health insurance news, NJ, NY News, Obamacare, Small Business Group Health
NYS 2019 Final Rates Approved
NYS has approved 2019 Final Rates last Friday. Small group rates will increase 3.8% and 8.6% for individuals.
As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers see original –NYS 2019 Rate Requests. Despite only 3 months of mature claims data experience for 2018 health insurers’ original requests were noticeably below average 7.5% for small group and 24% for individuals. Ultimately NYS reduced this request substantially by approximately 50%.
Experts are concerned over the long term effects. Example, the Individual mandate was removed last December by Presidential order. Without the Mandate anyone can drop insurance without penalty. A comparable take away for similar auto insurance industry would be something like this -Drivers ought not be mandated to buy auto insurance as its a profit scheme by Insurers. While a popular decision this will hardly bend the curve long term and reduce competition. Furthermore, the new order of Selling Across State lines makes NYS most unwelcoming.
Insurers have been filing to sell Obamacare plans that will go into effect in 2019, and in some states they appear to be pricing in for the fact that the mandate is going away next year. Other states are seeing mild increases, but that is in part because they saw significant hikes for the previous year.
Insurers have concluded that fewer people will enroll without the mandate than otherwise, so in some places they are pricing their plans higher based on the assumption that sicker people will be left behind, which will increase medical costs for those left. It is well worth pointing out that in recent years the loss federal risk reinsurance corridor funds account for 5.5 percent of the rate increase.
How are neighboring States doing?
In NJ, not that bad. Last year the average increase were 5.5% for small groups and some popular plans such as Horizon Blue Cross Blue Shield’s OMINA increasing only 4.8% increase. This year the increase is only 5.2. Other insurers offering EPO and HMO plans in the individual market for 2019 include Oscar Health and Oxford Health Plans.
With individual mandate repeal fewer people will buy health insurance raising the prices for those who do. NJ Banking and Insurance Department officials said premium prices would have increased, on average, by 12.6 percent.
For CT market, on the other hand, things are much worse at least for the individual marketplace with average 25% rate increases last year. The 2019 proposed rate increases for both the individual and small group market are, on average lower, than last year: The proposed average small group rate increase request is a 10.22 percent and ranges from -5.0 percent to 21.1 percent. This compares to the average increase request of 18.06 percent requested last year.The proposed average individual rate increase request is 12.3 percent and ranges from -10.9 percent to 31.0 percent. This compares to the average increase request of 25.51 percent requested last year.
Final plan rates in New Jersey & CT will be finalized and released in the fall, state officials said. ACA open enrollment begins Nov. 1
- Trend: Trend is a factor that accounts for rising health care costs, including the cost of prescription drugs, and the increased demand for medical services.
- Uncertainty in Washington:
- Removal of penalty for individual mandate: The elimination of the penalty means that individuals who are typically younger and healthier would have no inducement to participate in the insurance pool, which could further destabilize the market. Lack of participation shrinks the pool and increases the cost of insurance to the remaining members.
- Short-duration health plans and Association Health Plans: Still pending are final federal regulations on non-ACA compliant short-duration plans, which may have implications for the ACA risk pool. Also, Connecticut along with other state insurance regulators, are awaiting clarification from the federal government on new federal regulations allowing association health plans, which could further shrink the ACA risk pool.
A bipartisan group of congressional representatives has discussed an agreement to extend and guarantee the payments, but it’s unclear whether they could do so by the new filing deadline of Sept. 5. A lawsuit filed by Congress against the Obama administration to challenge the payments is still pending. In addition, Trump has repeatedly threatened to withhold payments to insurers that reduce cost-sharing – deductibles, copays and coinsurance – paid by low-income customers. More than half of New Jersey’s marketplace customers receive that assistance, and without it, most would be unable to afford coverage.
Finally, a tax on health insurance premiums has been reinstated in 2018 after a one-year “tax holiday” approved by Congress for 2017. That contributed 2.3 percent to the rate hikes that insurers requested for 2019 and for 2019
SMALL GROUP MARKET VS. INDIVIDUAL MARKET
Importantly, small group market is still more advantageous than individual markets unless one gets a sizable low-income tax credit. Overall, about 350,000 individual plan consumers will be affected by the price hike, while more than a million users will be hit by higher small group fees. Last year, Blue Cross Blue Shield released a study showing Obamacare user costs were 22 percent higher than people with employer-sponsored health plans, while UnitedHealth plans to exit most Exchanges see – Breaking: Oxford Exits Metro Indiv & Oxford Liberty HMO 2017.
The correct approach for a small business in keeping with simplicity is a Private Exchange and with our large buying group PEO partnerships. This is a true defined contribution empowering employees with a choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll. Both employee and employers still gain tax advantage benefits under the business. Also, the benefits, rates and network size are superior under a group plan as the risk are lower for small group plans than individual markets.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us at firstname.lastname@example.org or (855)667-4621.
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by Admin. | Jun 12, 2018 | family health insurance, Health Care Reform, Individual Exchanges, individual health insurance, latest health insurance news, NJ
New Jersey Enacts Individual Health Mandate
A new law entitled the “New Jersey Health Insurance Market Preservation Act” was signed by Governor Phil Murphy on May 30, 2018 to reestablish the recently repealed “shared responsibility tax”. The law, which will take effect on January 1, 2019, will require every New Jersey resident to obtain health insurance with minimum essential coverage or pay a fee, essentially adopting the rules of the ACA.
This legislation will directly impact residents of NJ and indirectly affect employers with employees residing in the state.
State Individual Mandate
The New Jersey Health Insurance Market Preservation Act will require all New Jersey residents to have Minimum EssentialCoverage (MEC) beginning January 1, 2019, or pay a penalty.
In light of Federal repeal on Dec 29, 2017, Tax Reform Bill Includes Repeal of Individual Mandate Beginning in 2019, NJ’s mandate is scheduled to take effect on January 1, 2019, making NJ the second state, after Massachusetts, to enactan individual mandate. The mandate includes an annual penalty of 2.5% of a household’s income or $695 per adultand $347 per child – whichever is higher. The maximum penalty is based on household income and will not exceed theaverage yearly premium of a bronze plan.If it’s based on a per-person charge, the maximum household penalty will be $2,085.
A “hardship exemption” will be available for individuals who cannot afford coverage, determined by the State Treasurer. NJ expects to collect between $90 million and $100 million in penalties. This money, along with additional federal funding, willbe used on a reinsurance program, which Murphy also signed into law.
While these bills do not directly affect employer sponsored plans, the individual mandate requirement for NJ residents will likely require education for employees. As residents in NJ will now be required to obtain health overage to avoid a state income tax penalty, employers may see an increase in plan enrollment. Unlike Massachusetts which requires specific coverage components, the NJ law only requires that coverage be MEC. Thus, most traditional employer-sponsored group health plans should meet this definition. However, coverage for only dental benefits, certain medical indemnity policies and vision benefits are likely not sufficient for purposes of avoiding the state tax. For now, employers with employees who reside in New Jersey may wish to educate employees at Open Enrollment that by January 1, 2019 health coverage will be required for NJ residents to avoid a penalty.
New Jersey lawmakers feared the repeal would drive healthier people out of the marketplace causing premiums to spike. They believe this law is pertinent to stabilize the marketplace, keep people insured, and prevent a death spiral of the individual market.
Resource:Obamacare Indivudal Mandate & Individual Mandate ACA Flow Chart and https://www.healthcare.gov/fees/fee-for-not-being-covered/
by Admin. | Dec 20, 2017 | Health Care Reform, Individual Exchanges, individual health insurance, Obamacare, Tax
Tax Reform Bill Includes Repeal of Individual Mandate Beginning in 2019
On Dec. 20, Congress passed the Tax Cuts and Jobs Act, which makes significant changes to individual and corporate provisions of the U.S. tax code, including a reduction in the corporate tax rate to 21%, down from 35%, beginning in 2018. The bill includes permanent effective repeal of the Affordable Care Act (ACA) individual mandate, requiring individuals to purchase and maintain health coverage, by zeroing out the penalty beginning in 2019. For 2018, most individuals are still required to maintain coverage or pay a penalty when they file their 2018 federal income tax return.
The bill was negotiated by a conference committee comprised of representatives from both the Senate and House after each chamber passed their own versions of tax reform. The final bill was passed 51-48 by the Senate and 224-201 by the House before being sent to the President. President Trump is expected to sign the bill into law soon.
The bill also changes how certain tax thresholds will be indexed for inflation. Affected provisions, including the ACA “Cadillac” Tax (scheduled to take effect in 2020), will now be indexed to the Chained Consumer Price Index (CPI) instead of the regular CPI (the previous metric). That change makes it likely that more employer-sponsored plans would trigger the Cadillac tax sooner.
We will keep our clients advised of timely developments of the Tax Cuts and Jobs Act as it relates to employee beneifts. For now, though, it appears that the biggest impactsthe next couple years are likely to be with respect to the individual mandate repeal and the Cadillac Tax changes.