Well, after a weird and interesting 2020, 2021 is here, and it's starting out just as weird and interesting as 2020!
But we here at Arizona Benefit Plans are hopeful for a successful 2021, and after seeing most employer groups accept their increased renewals in favor of stability in 2020, we think 2021 is going to be the year of change.
As in previous years, we are here to support your sales efforts, and are committed to providing the highest level of service, innovative and cost effective products, and to be your resource for everything self-funded!
We will be adding a couple new service enhancements this year including spreadsheet output of the products and pricing quoted that you can take right from your email inbox to a client, and a video training series on subject matter that we hope will be beneficial to you and your staff. Below are links to the first 2: PBM 101, and Referenced Based Pricing.
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On a personal note, I just want to say thank you for your partnership over the years. While the product set that I work with is interesting and fun, it’s the people and the organizations that I get to interact with every day that make my job enjoyable!
Cheers to a great 2021 (it will get better...I promise!)
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- Group Level questionnaire for groups 16 lives plus (previously 26 lives)
- BE WELL digital wellness platform in addition to the current Magellan program
- WebMD product
- Individualized based on goals, health risks and biometric screening results
- Employer dashboard to monitor employee engagement
- Personal health coach
- Group challenges
- Patient Assurance Program for those members who are on insulin
- $25 cap on insulin products for Humalog, Humulin, and Lantus
- EMI TPA Service
- All inclusive rate (network, plan doc preparation, ID card printing, etc.)
- Blue Cross network
- Can be used with any stop-loss carrier
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As the new logo indicates, National General was acquired by Allstate. Allstate has actively been in the voluntary benefit space for many years. With the purchase of National General, they now bring their brand strength and stability to medical benefits side. We do not anticipate any changes to the product set or focus.
If you have not had a chance to take a look at National General, now is the time. They are very competitive, innovative with their products, very flexible, and they make it easy to onboard groups.
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CIGNA PPO – Referenced Based Pricing Dual Option:
Trustmark will allow a dual option of a CIGNA PPO plan, and a referenced based pricing plan. Minimum of 26 lives enrolled, and a minimum of 25 lives enrolled on the CIGNA plan.
Trustmark also took a rate reduction at the beginning of the year, so we are seeing them as more competitive than we have in the past.
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90 Degree Benefits (a Blue Cross Blue Shield of Alabama company) acquired a majority share of Allied National at the end of last year.
90 Degree Benefits gives Allied National connectivity with some of the largest Regional TPA’s throughout the Country. Plus the stability and name recognition of a Blue Cross connected entity.
Don’t expect any changes to the product portfolio, or pricing.
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IRS Announces Adjusted PCORI Fee — AGENCY GUIDANCE, (Dec. 1, 2020) |
In Notice 2020-84, the IRS has provided the adjusted applicable dollar amount to be multiplied by the average number of covered lives for purposes of the fee imposed by Code Secs. 4375 and 4376 on the issuer of a specified health insurance policy for policy years and plan years that end after October 1, 2020, and before October 1, 2021.
The fee helps fund the Patient-Centered Outcomes Research Institute (PCORI).
The applicable dollar amount that must be used to calculate the fee imposed for policy years and plan years that end on or after October 1, 2020, and before October 1, 2021, is $2.66.
The PCORI was created by the Patient Protection and Affordable Care Act. The fee originally set to expire on October 1, 2019, but was extended until 2029 by the Further Consolidated Appropriations Act, 2020.
SOURCE: Notice 2020-84, I.R.B. 2020-51, December 14, 2020.
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2010–2019 Arizona Trends in Employer Premiums and Deductibles |
At the start of the pandemic, 160 million people in America had insurance through their employers. The pandemic’s disruption to the economy resulted in a loss of coverage for an estimated 14.6 million workers and their dependents by June of this year.
Millions who still have employer benefits have lost wages and income, making their insurance costs an increased burden on household budgets. The ACA is meant to provide a safety net for people who lose employer coverage by offering coverage through the individual market and the marketplaces or Medicaid. However, while people with unaffordable employer plans have some options through Medicaid and the marketplaces, these options are limited and eligibility rules are complex, according to a data analysis conducted by the Commonwealth Fund.
The total cost of premiums and potential spending on deductibles across single and family policies has ranged from a low of $5,535 in Hawaii to a high of more than $8,500 in nine states.
If premiums and deductibles do not fall this year, household income lost during the current economic crisis will increase cost burdens for middle-income families.
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Workers’ premium contributions were 8% or more of median income in nine states in 2019. In Arizona last year, employee premium contributions were $4,463 – 6.6% of the state’s median income. The average deductible for single coverage for the state was $2,418, the second-highest after Montana.
Average deductibles were 5% or more of median income in 20 states in 2019. In Arizona, employee deductibles were $3,618, 5.3% of the state’s median income.
In most states, even though people are paying high premiums relative to their income, they are potentially exposed to high out-of-pocket costs because of large deductibles. High deductibles can act as a financial barrier to care, discouraging people with modest incomes from getting needed services. This a particular problem during the COVID-19 pandemic, when people with symptoms may delay care because of cost concerns.
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