The Health Shopper

As of today almost all employer-sponsored health plans will be required to cover contraceptives without deductibles, co-pays, etc. 28 states currently require health plans to cover contraceptives to some extent; the new ruling has made them completely cost-free.
The only exception is religious organizations, nonprofits, and places of worship that employ individuals of the same faith.

Last week Microsoft announced its new joint venture with GE, an open tech platform that would allow for “better population health management”. The as-yet-unnamed venture plans to develop clinical health care applications that would bring various healthcare IT products together. Microsoft will be providing technologies such as Amalga, expreSSO, and Vergence, while GE will be contributing Qualibria and its eHealth health information exchange. An interesting pairing: two multinational conglomerates, one joint health care venture.

Today, the provision known as the Medical Loss Ration will drop. This provision requires health insurance companies to spend 80% of their consumers’ premiums on medical care, as opposed to marketing or overhead costs. If they do not do this, the companies will be required to send back a rebate check detailing the amount they did not spend on medical care.

The Department of Health and Human Services has detailed the parameters for qualification as a medical expenditure, though these rules are still being “fine-tuned”.

In the past, employers have offered various weight loss, diet and nutrition, and smoking cessation classes, but the programs have done little to ameliorate poor health practices – and they’ve failed to pull in a crowd. Now, along with the free programs, many employers are tacking on much higher premiums for unhealthy employees.

While the programs will remain voluntary, employees will likely find that utilizing them will be beneficial in the long run. From lowered premiums to employer bonuses to HSAs, the financial rewards for taking advantage of the programs are likely to be a big push for employees. For example, Union Pacific employees can currently receive up to $300 in employer contributions to their HSAs if they complete a provided health assessment, don’t use tobacco, and go in for an annual physical.

According to Reuters almost 40 percent of employers will begin hiking premiums for unhealthy employees in 2012, more than doubling the 19 percent of employers using the penalty strategy this year.

Earlier this week we reported on open enrollment 2011-2012. Wall Street Journal just came out with a helpful article examining significant aspects of this season’s open enrollment. Here are the highlights:

• Many employees will face increased out-of-pocket expenses, which are the charges they pay for health-care services. Notably, there will be a jump in the use of high deductibles—the upfront sums employees pay before coverage kicks in. To help workers defray those costs, some employers are offering financial incentives to those who make efforts to track and improve their health.

• Employees also will likely see at least small upticks in their monthly premiums for coverage, while some employers are trimming costs by offering a smaller array of doctors and hospitals.
• Even if employees opt for the same plan they had last year, they should watch for changes that might not be obvious, such as having to pay more to use medical providers that are outside the insurer’s network.
• You should delve into the details of plans’ charges before you choose one. Keep an eye out for where you will owe co-insurance, which is a percentage of the cost of care and tends to be more expensive than a flat co-pay, and for fees that may not count toward your out-of-pocket maximum.
• For consumers, a health savings account—which can be set up by people whose health plans meet certain requirements, such as high deductibles—has some advantages over other types of accounts. Unlike a flexible spending account, which is another type of tax-free account linked to health expenses, an HSA’s contents can be held over from year to year. Moreover, an HSA stays with you if you move to a different employer, and it can be used to save for medical expenses in retirement.

Folks, open enrollment season has rolled around once more! The exact dates vary, but enrollment typically begins around mid-to-late October and ends early in November. Here’s a rundown of the changes this enrollment season:

Health care costs have been risins across the board, both for providers as well as consumers. As a result, employers are likely to increase health insurance premiums by almost 12 percent according to consultancy Towers Watson, as well as switch from co-pays to coinsurance for doctor’s visits. Employers also plan to offer more high-deductible plans, which have lower premiums and up-front costs but can cost much more down the line.

Opening an HSA could be a great way to save should out-of-pocket expenses shoot up, and some companies contribute to employee HSAs each month. Many employers also offer wellness incentives, which could add up over the year. On the whole providers and employers are pushing wellness and preventive care to encourage healthy practices.
Be sure to get insured this enrollment season!

More and more, families are looking to public health insurance options for their children’s coverage thanks to greater access to public plans and job losses, according to a recent study by the University of New Hampshire. This seems to be particularly true for more rural as well as inner-city areas where overall coverage rates have generally been lower than suburban areas.

According to the researchers, unemployment is the key factor in the trend. With unemployment, employer-provided coverage is usually terminated and due to the drop in income families and individuals often become newly qualified for public plans. Eligibility for health insurance plans has also been expanded, which helps push families and individuals in making the choice to go to public insurance. The research also uncovered an unfortunate situation: nationwide, about 9 percent of children do not have any type of coverage; over half of them are eligible for coverage through Medicaid and/or SCHIP.

“Research demonstrates that most of these eligible children come from states with low participation rates and are disproportionately Hispanic. Because those who have health insurance are healthier overall and, more importantly, because healthy children are more likely to become healthy adults, focusing on covering eligible children should remain at the forefront of the nation’s agenda,” the researchers said.

The non-partisan Institute of Medicine has recommended making birth control available to women for free as preventive care under health reform. The jury is still out on this one, but what do you think — should contraceptives be provided as preventive care for women?