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group medical insurance

Medical Loss Ratio Rebates

Zinser · June 26, 2012 · Leave a Comment

A few points to mention:

  • This represents less than 10% of private health insurance consumers
  • The average rebate is $151/family
  • A small percentage will actually see a check b/c if you currently acquire your health insurance through your employer, the employer will get the insurance rebate check – however, most carriers are not wanting to issue checks, so they will be offering future savings instead of individual checks
The following was taken from healthcare.gov website

On June 1, 2012 health insurance companies nationwide submitted their information in regards to Medical Loss Ratios.  Below is what this amounts to.

Because of the Affordable Care Act, insurance companies now must reveal how much of premium dollars they actually spend on health care and how much they spend on administration, such as salaries and marketing. This information was not shared with consumers in the past.  Not only is this information made available to consumers for the first time, If an insurance company spends less than 80% of premiums on medical care and quality (or less than 85% in the large group market, which is generally insurance provided through large employers), it must rebate the portion of premium dollars that exceeded this limit.[1] This 80/20 rule is commonly known as the Medical Loss Ratio (MLR) rule.

On June 1, 2012, insurance companies nationwide submitted their annual MLR reports for coverage provided in 2011 to the Department of Health and Human Services (HHS). Based on this data, insurance companies that didn’t meet the 80/20 rule will provide nearly 12.8 million Americans with more than $1.1 billion in rebates this year. Americans receiving the rebate will benefit from an average rebate of $151 per household.

Under the new health care law, rebates must be paid by Aug. 1 each year. As a result, 12.8 million Americans will see one of the following:

  • a rebate check in the mail
  • a lump-sum reimbursement to the same account that was used to pay the premium if it was paid by credit card or debit card
  • a direct reduction in their future premiums
  • their employer providing one of the above rebate methods, or applying the rebate in a manner that benefits its employees.

Appendix II: Total Rebates by Market and State for Consumers and Families: Table shows state by state rebate data for the individual market, small group market, and large group market.

Appendix II: Total Rebates by Market and State for Consumers and Families

To see full results, here’s the link:

http://www.healthcare.gov/law/resources/reports/mlr-rebates06212012a.html

FDA may let patients buy drugs without prescriptions – Washington Times

Zinser · April 30, 2012 · Leave a Comment

Doctors can’t be happy with this

 

FDA may let patients buy drugs without prescriptions – Washington Times.

Health insurer rebates to top $1 billion | BenefitsPro

Zinser · April 27, 2012 · Leave a Comment

Interesting read.  Something that probably wouldn’tve happened without Health Care Reform. 

 

Health insurer rebates to top $1 billion | BenefitsPro.

 

 

IRS issues guidance on W-2 reporting

Zinser · January 20, 2012 · Leave a Comment

On January 3, 2012, the IRS issued additional interim guidance on the W-2 reporting requirement that is part of health care reform. In this guidance, the IRS confirms that employers filing fewer than 250 W-2s are not required to report the value of health benefits. This guidance extends that relief until further guidance is issued.

Additionally, the release indicates that specialty coverage, if included with medical benefits, must be reported.

The guidance reaffirms that this is a reporting requirement only and does not impact employees’ taxable wages.

Questions and Answers:

Q:   Are specialty products, if offered as one plan to an employee, included in the W-2 reporting requirement?

A:    According to the latest guidance from the IRS, yes. If the products are embedded or provided together, the total must be reported.

Q:   How do contingent premium groups report the value of health benefits under the W-2 reporting requirement?

A:    Please refer any customers with this question to their own tax and/or legal advisers as we do not provide tax advice. The latest information from the IRS related to the W-2 reporting requirement can be found at http://www.irs.gov/pub/irs-drop/n-12-09.pdf and may provide additional guidance.

Generic for Lipitor Now Available

Zinser · December 10, 2011 · Leave a Comment

On November 30, 2011 Ranbaxy Laboratories launched the generic equivalent for Lipitor, atorvastatin.  Ranbaxy will be the sole manufacturer of this generic drug for the next 180 days.  Other manufacturers of the drug will be available in May 2012.

The savings at the beginning will be minimal, but once May 2012 roles around we should see substantial savings.  This means big savings to consumers and payers alike.

 

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Zinser Benefit Service - Small Business Insurance

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