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.
OTHER STATES
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 info@medicalsolutionscorp.com or (855)667-4621.
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by Admin. | Jul 27, 2018 | healthcare, HSA
HSA 2019 Limits
The IRS has released the 2019 Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.
New HSA 2019 limits are as follows:
Age 55 Catch Up Contribution-As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of year, you can contribute additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute additional $1,000.
HSA/HDHP Market Growth
HSA holders own the assets in the accounts and can build up substantial sums over time. Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.
HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.
- The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
- 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
- 14% of all workers in the private sector that have access to a Health Savings Account acc. to Bureau of Labor Statistics.
- States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois and Minnesota.
HSA Advantages:
- Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
- Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
- Tax Free Money allowed for non traditional Medical coverage– As per IRS Publication 502, unused moneys can be used for dental,vision, lasik eye surgery, acupuncture, yoga, infertility etc. Popular Examples
- Portability – The funds belong to you, so you keep the funds if you change jobs or retire.
Our overall experience with HSAs have been positive when employer funding is at minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money). Traditional plans trend of higher copays and new in network deductibles has also led to the popularity of an HSA.
IRS Update on Other Spending Limits (11/15/18):
The contribution limit for dependent care accounts (DCAs) are fixed as $5,000 per household or, if married and filing separately, $2,500 per taxpayer.
Is your HSA compliant? Which pre-tax qualified HSA, FSA, HRA spending card is right for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers. Stay tuned for updates as more information gets released. Sign up for latest news updates.
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by Admin. | Jun 3, 2018 | healthcare, NJ
No More Surprises – NJ Surprise Medical Bill Law
New Jersey Governor Phil Murphy (D) signs law to take in effect within 3 months that will reduce Surprise Out-Of-Network Medical Bills.This is well needed and in-step with NYS law passed 3 years ago – No More Surprises – NY Surprise Medical Bill Law.
The reform is designed to protect patients, businesses, and others who pay for medical care from the high-cost bills associated with emergency or unintentional care from doctors or other providers who are not part of their insurance network. The law requires greater disclosure from both 
insurance companies and providers — so patients are clear on what their plan covers — ensures patients aren’t responsible for excess costs, and establishes an arbitration process to resolve payment disputes between providers and insurers, a mechanism intended to better control costs.
The Problem. This has been a pattern in recent years and posted in Out of Control Out of Network Charges (March 2012). According to an investigation report commissioned by Governor Cuomo recognizing the unexpected out-of-network claim problem. Officials say that this is now “an overwhelming amount of consumer complaints.” Some examples cited in the report An Unwelcome Surprise – “a neurosurgeon charged $159,000 for an emergency procedure for which Medicare would have paid only $8,493.” Another example: ” a consumer went to an in-network hospital for gallbladder surgery with a participating surgeon. The consumer was not informed that a non-participating anesthesiologist would be used, and was stuck with a $1,800 bill. Providers are not currently required to disclose before they provide services whether they are in-network.” The average out-of-network radiology bill was 33 times what Medicare pays, officials say.
The blog post goes on to say “Today, 90% of SMB members have in network only benefits but the few remaining consumers are paying for eroding out of network benefits with little transparencies and necessary protection from new out of network billing practices. The NY Dept of Financial services is calling for providers in non-emergency situations to disclose whether or not all services are in-network, what out-of-network charges will be and how much insurers will cover.”
The Solution: The The out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act requires greater disclosure from both insurance companies and providers — so patients are clear on what their plan covers — ensures patients aren’t responsible for excess costs, and establishes an arbitration process to resolve payment disputes between providers and insurers, a mechanism intended to better control costs. The law sets a timeline and other parameters for negotiations between the payer and the provider and, if they can’t resolve the issue, requires the state to hire an independent expert to decide between the final offers presented by both sides. While earlier drafts of the bill included a range of factors for the arbitrator to consider in making this decision — including the doctor’s experience, the patient’s condition, and certain payment benchmarks — these details were eliminated entirely in the final version.
NJ becomes the 7th State to enact such consumer protection. The other states include California, Connecticut, Florida, Illinois, Maryland and New York.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us – info@medicalsolutionscorp.com or (855)667-4621.
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by Admin. | Aug 20, 2017 | family health insurance, group health insurance, Health Care Reform, healthcare, Individual Exchanges, individual health insurance, latest health insurance news, NY News, Obamacare, Small Business Group Health, State Exchanges
NYS 2018 Final Rates Approved 
NYS has approved 2018 Final Rates last week. Small group rates will increase 9.3% while the individual rate average increase will be 13.9%.
As per NY State Law carriers are required to send out early notices of rate request filings to groups and subscribers see original –NYS 2018 Rate Requests. With only 3 months of mature claims, experience for 2017 health insurers’ requests are historically above average. Ultimately the State reduces this request substantially. This year, however, NYS acknowledged that medical costs increased, citing a 7-percent average increase on the individual market and an 8.5-percent increase on the small group market. The administration also acknowledged drug prices have impacted insurers, pointing specifically to blockbuster drugs for Hepatitis C.
OTHER STATES
The national rate trend, however, has been much higher than in past years due to higher health care costs Like other states throughout the nation, the 2017 rate of increase for individuals in New York is higher than in past years partly due to the termination of the federal reinsurance program. The loss of the program’s a.k.a. federal risk reinsurance corridor funds account for 5.5 percent of the rate increase.
How are neighboring States doing? In NJ, not that bad. According to a review of filings made public last week the expected rate increase will likely be half. Example: Horizon Blue Cross Blue Shield requested a 4.8% increase on their OMINA Plans. For CT market, on the other hand, things are much worse at least for the individual marketplace with average 25% rate increases.
While the individual mandate is still the law, Washington has made it clear that they aren’t going to enforce the mandate. That means fewer people will buy health insurance raising the prices for those who do.
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 is due to be 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 last year.
SMALL GROUP MARKET VS. INDIVIDUAL MARKET
The new premium hikes ranged from as little as .8% percent for Hudson Valley’s Crystal Run Health Insurance Company to a whopping 20.4% percent increase for Albany region’s CDHP. 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.
* All amounts are rounded to the nearest 1/10.
**Indicates that the company makes products available on the “New York State of Health” marketplace.
Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.
Newsletter Sign Up Now
by Admin. | May 5, 2017 | healthcare, HSA, Tax
HSA 2018 Limits
The IRS has released the 2018 Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.
New HSA 2018 limits are as follows:
HSA Annual Contribution Limit:
Single – $3,450 ($3,400 in 2017)
Family – $6,900 ($6,750 in 2017)
Catch-up – $1,000 ($1,000 in 2017) for age 55+.
HDHP Minimum Annual Deductible:
Single – $1,350
Family – $2,700
HDHP Out-of-Pocket Maximum:
Single – $6,650 ($6,550 in 2017)
Family – $13,300 ($13,100 in 2017)
Age 55 Catch Up Contribution-As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of year, you can contribute additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute additional $1,000.
HSA/HDHP Market Growth
HSA holders own the assets in the accounts and can build up substantial sums over time. Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.
HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.
- The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
- 30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the remaining 20 percent were in the individual market.
- 14% of all workers in the private sector that have access to a Health Savings Account acc. to Bureau of Labor Statistics.
- States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois and Minnesota.
HSA Advantages:
- Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
- Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
- Tax Free Money allowed for non traditional Medical coverage– As per IRS Publication 502, unused moneys can be used for dental,vision, lasik eye surgery, acupuncture, yoga, infertility etc. Popular Examples
- Portability – The funds belong to you, so you keep the funds if you change jobs or retire.
Our overall experience with HSAs have been positive when employer funding is at minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money). Traditional plans trend of higher copays and new in network deductibles has also led to the popularity of an HSA.
Is your HSA compliant? Which pre-tax qualified HSA, FSA, HRA spending card is right for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers. Stay tuned for updates as more information gets released. Sign up for latest news updates.
RESOURCE:
by Admin. | Oct 28, 2016 | healthcare, Hospitals
Top 10 medical innovations for 2017
The Cleveland Clinic announced its list of the top 10 medical innovations for 2017 that have the potential to transform healthcare.
The 11th annual list was announced Wednesday during the Cleveland Clinic 2016 Medical Innovation Summit, held this week at the Huntington Convention Center of Cleveland and the adjacent Global Center for Health Innovation.
A team of more than 100 doctors and researchers assembled by the Clinic examined nearly 200 nominations to identify and rank the top 10 innovations. The panel doesn’t highlight brands or companies, but rather the innovation and its potential applications in healthcare.
The Top 10 Medical Innovations of 2017 are listed below in order of anticipated importance:
1. Using the microbiome to prevent, diagnose and treat disease
Trillions of bacteria in the body make up communities known as the microbiome. Within the last 10 years, researchers have discovered that the chemicals microbes emit can interfere with how food is digested, medicine is deployed or how a diseases progresses.
The National Microbiome Initiative has accelerated research and development, and biotech companies are looking at the microbiome’s potential to develop new diagnostics or therapies and probiotic products to prevent microbe imbalances.
Experts believe that next year the microbiome will solidify itself as “the health care industry’s most promising and lucrative frontier,” according to a news release.
2. Diabetes drugs that reduce cardiovascular disease and death
In the past, medications have fallen far short of addressing the mortality rates for type 2 diabetes. Half will die from complications from cardiovascular disease. Those odds reach 70% after the age of 65. But new medications began dropping mortality rates this year.
Empaglifozin modifies the progression of heart disease by working with the kidneys, and liraglutide has a comprehensive effect on many organs, according to the release.
2017 could bring a complete shift in the medicines prescribed and further research into new ways to target type 2 diabetes, experts predict.
3. Cellular immunotherapy to treat leukemia and lymphomas
One of the first cellular immunotherapies is about to hit the market, and early results suggest leukemia and non-Hodgkin lymphomas might be curable, even in advanced stages, according to the release.
Chimeric antigen receptor (CAR) T-cell therapies are a form of immunotherapy in which T-cells are removed and genetically reprogrammed to find and destroy tumor cells. After attacking and killing foreign cancer cells, they often remain to minimize the risk of relapse.
The treatment, results for which have been impressive, is expected to be presented to the U.S. Food and Drug Administration next year for treatment for acute lymphoblastic leukemia.
4. Liquid biopsies to find circulating tumor DNA
“Liquid biopsies” are blood tests that uncover signs of actual DNA, or cell-free circulating tumor DNA (ctDNA), which is shed from a tumor into the bloodstream and is more than 100 times more abundant in blood than tumor cells.
Several companies are developing testing kits expected to hit the market this year.
Liquid biopsies are being hailed as a flagship technology of the Cancer Moonshot Initiative, a national effort to end cancer.
5. Automated car safety features and driverless capabilities
New automatic safety features could make a dent in dangerous car accidents, which remain a leading cause of death and disability as well as a major expense. In 2015, there were 38,300 fatal car crashes in 2015, and medical costs nationwide in one year total nearly $23 billion nationwide.
The automated features include collision warning systems, drowsiness alerts and adaptive cruise control. More are likely coming.
Though legal and safety questions remain, major investments into driverless cars are being made by software, private transportation and auto manufacturing companies.
6. Fast healthcare interoperability resources
For many years, billing departments, doctors’ offices, insurance companies and more have operated with systems that couldn’t talk with each other. Experts predict that 2017 is the year to make sense of this tangled web.
An international committee called HL7 will soon release a new tool, FHIR (Fast Healthcare Interoperability Resources), which will serve as an interpreter between systems or offices. The first release will focus on clinical data while the second will look at administrative data, with the potential to end a lot of frustration.
7. Ketamine for treatment-resistant depression
For one third of patients with depression, medications don’t work. Alternatives include intensive treatment options, such as electroconvulsive therapy.
Initial studies of ketamine, a drug commonly used for anesthesia, indicated that 70% of patients with treatment-resistant-depression (“TRD”) saw an improvement in symptoms within 24 hours of a low-dose injection. Ketamine, also known in the 1960s as a party drug, was studied for its ability to target and inhibit the action of N-methyl-D-aspartate (“NMDA”) receptors of nerve cells.
The FDA granted Fast Track Status to the development of a new NMDA-receptor-targeting medications based on the ketamine profile. The FDA gave some, like esketamine, breakthrough status, enhancing the potential for these drugs to be available to patients in 2017.
8. 3D visualization and augmented reality for surgery
Two of the most intricate surgical practices, ophthalmology and neurology, began experimenting in the past year with technology that allows surgeons to keep their heads up while using high-resolution, 3D visual representations of their subjects.
Using data, stereoscopic systems create visual templates. Surgeons who’ve piloted the technology say it brings added comfort and visual information that allows them to operate more effectively and efficiently while also giving medical residents a clear picture of what they’re doing.
Augmented reality glasses that display holographic images of human anatomy could bring the end of cadaver labs at medical schools.
Along the same lines, software companies are building augmented reality glasses that display holographic images of human anatomy. Medical schools see the end of cadaver labs. The Clinic and Case Western Reserve University were among the early adopters to work with Microsoft’s HoloLens, a mixed reality device that allows users to interact with holograms.
9. Self-administered HPV test
Most sexually active woman contract the human papilloma virus (HPV), certain strains of which are responsible for 99% of cases of cervical cancer. The most common malignancy is in women 35 years and younger.
HPV prevention and treatment, which have made great strides, are restricted to women who have access to tests and vaccines.
An approach to expand that care will launch in 2017 with self-administered HPV test kits developed by scientists with the idea that women can mail samples to a lab and be alerted to dangerous HPV strains.
10. Bioabsorbable stents
In July, the first bioabsorbable stent was approved in the U.S. The stent, made of a naturally dissolving polymer, widens clogged arteries for two years before being absorbed much like dissolvable sutures, leaving behind a healthy natural artery.
Annually 600,000 people are treated for coronary artery blockage with metal coronary stents, which stay in their chests permanently most of the time. These stents may inhibit natural blood flow or cause other complications.
Experts believe the market potential for absorbable stents will approach $2 billion in six years.
“Cleveland Clinic announces top 10 medical innovations for 2017” originally appeared in Crain’s Cleveland Business.
