Wednesday, April 29, 2015

Redefinition of Small Group

2016 is shaping up to be yet another impactful Affordable Care Act (ACA) year, particularly for employers with 51-100 employees (full and part-time). The two year reprieve from the ACA’s employer mandate/share responsibility for such employers ends beginning in 2016. But perhaps more importantly, and having a potentially greater impact, is the redefinition of what constitutes a so called SMALL EMPLOYER. Plans that begin or renew on or after 1/1/2016 that are: (i) fully insured; (ii) non-grandmothered*; and (iii) have 1-100 employees, will be required to comply with certain ACA regulations heretofore applicable only to fully insured groups with fewer than 51 employees. Let’s take a look at the impact of this redefinition…

Wednesday, April 15, 2015

Healthcare Payment Alternatives

Back in the 1960’s, the average cost of an overnight hospital admission was around $100. Not coincidentally, most health insurance plans at the time set their deductible amounts somewhere between $0 and $100. Today, adjusting for geographical differences, PPO discounts, etc., an overnight stay in a hospital will run you between $1,700 – $2,500. According to the Kaiser Family Foundation (KFF), the average health insurance plan deductible in 2014 for an individual covered by employer based coverage was $1,214 (up from $826 in 2009). Smaller employers (fewer than 200 employees) tend to have higher deductibles (nearly $1,800); while larger employers lean toward lower deductibles ( $971). Clearly, there is a relationship between health insurance deductible amounts, and the average cost of an overnight hospitalization.