January 1 is renewal time for many employer groups and individuals, and the one question on everyone’s mind is, “How much will my premiums increase?”

There’s no one-size-fits-all answer to this question, but according to an annual health care survey by the National Business Group on Health, most employers can expect the cost of medical and drug benefits to rise by at least 5% in 2019.

At Partners Benefit Group, we do expect some groups will see lower increases, if any at all, and others will face higher rates. We also anticipate that the majority of employers will continue to offer their employees high-deductible plans tied to a health savings account as a way to manage costs.

For those that buy individual health insurance policies, the renewal rates are anticipated to vary widely. In Georgia for example, there are four carriers that participate in the state insurance exchange. Alliant Health Plans and Anthem Blue Cross and Blue Shield have reported that premiums will actually drop by a nominal amount this year, bringing good news to its members. Ambetter of Peach State and Kaiser Permanente are reporting increases, however.

In a recent development, Blue Cross is expanding the number of counties in which it will offer ACA-compliant plans next year. In fact, most of metro Atlanta will be able to choose Blue Cross in 2019, which gives some individual buyers of health insurance a choice this year between carriers.

Here are three important things to know if you’re buying individual insurance in 2019:

  1. You won’t face a tax penalty in 2020 if you opt out of health insurance. But, being uninsured is risky move. One serious claim can be financially devastating.
  2. Open enrollment is only from November 1, 2018 – December 15, 2018; shorter this year so get organized early.
  3. Subsidies to ease the cost of health insurance premiums have increased. Check Healthcare.gov to see if you qualify.

Telemedicine, A Winner in Reduced Claims!

     Mercer’s National survey of Employer-sponsored Health plans noted a significant savings when members have telephone visit access to physicians.

     According to the Mercer survey, Telemedicine offerings by large employers surged to 59% this year as compared to the 30% in 2015. Telemedicine plans are also becoming very popular with small to medium size businesses.

     The key to the success of the program is utilization of the benefit. From our experience, if the benefit requires a co-pay for the consultation, the utilization will be very low, and the employees will not take advantage of the tremendous benefits of this program. That is the reason our plan requires NO CO-PAY and covers the entire family.

     In our agency, we have a group that has a savings YTD of over $200,000 in reduction of medical visits at doctor offices and the ER. It is a proven fact that a viable Telemedicine program can reduce medical claim utilization by as much as 70% if the employee has a direct 800 number to talk to the doctor.

The Wall Street Journal (2/22, Tergesen, Subscription Publication) reports that beginning in 2019, Medicare beneficiaries with high incomes must pay a larger share of their medical costs. This article says this is another attempt to transfer more Medicare costs to the wealthiest seniors. The piece adds that as of next year, beneficiaries who have incomes of $500,000 or more and couples with the income of &750,000 or more will be placed into a new category and asked to pay 85% of what their parts B and D benefits cost. At present, they are paying 80% of those costs.

PACE Act Signed

ACA Small Group Market Rule Repealed

On Oct. 7, 2015, President Obama signed the Protecting Affordable Coverage for Employees (PACE) Act into law. The PACE Act repeals the Affordable Care Act (ACA) requirement that the small group market in every state be expanded to include businesses with 51-100 employees.

Although some sources questioned whether he might veto the law, the President signed the PACE Act into law in light of its bipartisan support in Congress.

To read this entire Health Care Reform Bulletin click here.