by Admin. | Aug 7, 2009 | COBRA, Dependent Coverage, family health insurance, group health insurance, individual health insurance, latest health insurance news, NY News
As expected, Governor David Paterson has signed 3 of his healthcare reform proposals into law, to wit:
S.5471 (Breslin) / A.8400 (Peoples) – extends state mini-COBRA from 18 to 36 months. Effective date is July 1, 2009 and shall apply to all policies and contracts of insurance issued, renewed, modified, altered or amended on or after such date.
S.6030 (Breslin) / A.9038 (Morelle) – allows for dependent care coverage of children up to 29 years of age. Effective date is September 1, 2009 and shall apply to all policies and contracts of insurance issued, renewed, modified, altered or amended on or after such date.
S.5472-A (Breslin) / A.8402-A (Morelle) – HMO reform act. Various effective dates depending upon the specific provision of the bill.
Here’s a link to the Governor’s Press Release announcing the same:
Article in Newsday – “New state law eases medical coverage for 20-somethings”
by Admin. | Jan 16, 2009 | healthcare, HSA, NY News, Pharmaceutical Industry
Happy Holidays!
We are pleased to present the Winter issue of the MMS newsletter. As we enter 2009 we want include some timely information on year end tips, house cleaning and helpful articles.
As guidance for 2009, we are seeing various industry patterns. These are heady economic times and we remain cautiously optimistic with the new presidential administration. There are many proposed legislations on the table as well as free reports from PriceWaterHouse Cooper reports on what “Employers Want” and “9 Trends for 2009”.
We have seen recent consolidations with recent mergers between GHI and HIP to form EmblemHealth. Both non profits follow the Empire Blue Cross for-profit conversion of 5 years ago and covered in my blog.
Insurers such as Aetna, Empire and Oxford have been dropping Pharmaceutical Benefits Management companies and using their own resources instead. As self acting PBMs’ they can negotiate effectively by using their large numbers. This trend has not gone unnoticed by Pharmacy retailers such as CVS and Walgreens who must compete with mail order PBMs’.
Pharmaceutical Corps are bracing themselves for brand expirations on 80% of the most commonly prescribed drugs within 2 years. They have issued double digit rate increases while simultaneously manufacturing generics of their own drugs. This will make sense as generics average 1/4 the cost of brands. In fact, this will be a significant future cost saver as Rx have doubled in 10 years and represents over 25% of our insurance costs.
Insurers are saving members 20-40% by including value added discounts or reimbursements for gym membership, weight management programs, alternative medicine & holistic healing, vision, laser vision care, dental , hearing care and vitamins/natural supplements.
The technology investments will improve patient care and the public is already seeing early payoffs. Various online medical sites have helped inform patients and advocacy. Insurers such as Empire actually offer a $5 Copay to interact with one’s doctor online.
In addition, “consumer driven healthcare plans” are taking off as copays have risen. Its not unusual to find plans with specialist $50 copay. As a result our consumers have been re-evaluating whether it makes sense to self insure on rare items such as hoispiatls and surgeries. The HSA (health Savings Account) a model, especially the one form Aetna, has become actually a high end plan since the savings are significant enough to self insure and have universal coverage. The average PPO plan is $650/single while an HSA at $370/single only asks that you self insure on $1500. The invisible hand leading you say? Agreed!
Perhaps things will be more localized as hospitals have consolidated and have a virtual monopoly in LI and Bronx as an example. Insurers such as Oxford, Aetna and Atlantis already offer localized NYC plans which are 30% less expensive but have a limited NYC network.
Our agency has strived to be ahead of the curve and keep our clients within budget regardless. We have employed creative tools, personalized advise and latest technologies in the past and plan on adding to this model going forward. We thank you all for reading our material, referring us business and most of all believing in us!
Once again thank you and we wish you and your family a wonderful Holiday Season!
by Admin. | Mar 27, 2008 | NY News
HIP and GHI merger. GHI and HIP have been working since 2005 on merging under a common parent, EmblemHealth, serving more than four million members across the tri-state area. As sister companies, GHI and HIP has continued to operate separately until they get NY State Approval. Affiliation is the first step as GHI and HIP begin the process of combining and integrating as they move toward an eventual merger. Existing group coverage will not change as a result of the affiliation. Over time, their stated mission is to will develop and make available an expanded range of cost effective products and new services to you and your employee’s. There have been a recent executive fall out of the changes and expect more to come. NY will be losing the last few non-profits left in the state. The state is running public forums to review this, see state insurance site on recent meetings. Will this be NY State politics as usual and allow political leaders to dole out the stock market gains for personal gains or will citizens stand to gain? Unlike our state, California took a long term view for the medical care of its citizens. They set up a non-profit with a mission that the Blue Cross conversion set up a fund of not less than $100 million to be spent on charitable activities in 1994 and not less than 40 percent of WellPoint stock ($1.2 billion) to be contributed to a newly formed foundation. Pataki on the other hand used 90% of the $1.1Billion Empire Blue Cross 2002 conversion for Mr. Rivera’s powerful 1199 Union. I’m sure that this did not harm his 2002 reelection campaign but I wish New Yorkers did as well as California. See article in NY Times for your consideration.
