News and Blog

Monday, 16 July 2018
TN health insurance rates are going down in 2019
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It's been a long time since we could say "your rates are going down" rather than "rates are going up and so is your deductible". We have wondered where the tipping point will be for affordability for consumers and profitability for the insurance companies, maybe we have finally reached it. This morning as I watched the news which is full of commercials promoting $5,000 per month medications that are "free" to consumers if you have commercial insurance, I scratch my head and wonder when the madness will stop. Well it's not stopping but at least it may not cost as much next year. 

In August, 2018 BCBST reduced their base rates in the middle market for Tennessee group insurance customers by around 15%. This was HUGE and a tremendous relief to hard hit businesses and employees. Now it looks like the small group EHB plans and individuals will see some rate relief for 2019. Those rates are filed annually and can't be changed until January 1st. BCBST is proposing an average decrease of 10.9% and Cigna will reduce costs by an average of 4.8%. We should know what small groups are getting by early August, my fingers are crossed. 

Obamacare changed the rules when it forced insurance companies to offer coverage with no exclusions, limitations or pre-existing conditions. The carriers did not really know how to price a policy like this and BlueCross BlueShield of Tennessee came out with some really attractive rates. After loosing hundreds of millions of dollars the incremental increases trippled the premiums. In 2015 rates increased by 19%, 36.3% in 2016, 62% in 2017 and 21% in 2018. Cumulatively, that is a 318% increasing taking a $100 monthly premium in 2014 and costing nearly $318 today. 

For the small business owner the increases have not been that extreme but it's still been very painful. I had a group who recently tried to offer a group medical plan to their employees only to have all 10  employees say they could not afford or did not want the plans. The company was going to pay 50% of the cost but still it was unattractive to the employees, that is not a good thing. 

Read more here

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Posted on 07/16/2018 7:36 AM by David Moore
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Friday, 6 July 2018
Good news - Bad news - Insurers fight Rx discount cards
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The ongoing battle over high prescription costs is taking another turn. With many specialty prescriptions costing $5,000 per month or more, drug companies figured out by offering pricing assistance until an employee hits the deductible, they could sell a lot of drugs. This created a tremendous challenge for insurers trying to control costs in light of all the direct to consumer advertising. 

The latest move by insurers - effectively forces drug companies to pay more to assist patients with their copays - is causing a decline in real US drug prices this year for those companies adopting the strategy and is expected to become more widely adopted in 2019 and beyond. 

The good news is this can slow the ever increasing cost of healthcare. The bad news is employees and patients who really need these expensive drugs can find themselves unable to afford them. 

Essentially what the "copay accumulator" does is prevents the copay card funds from counting toward a patients out of pocket maximum. Once the out of pocket maximum is reached the insurer pays 100% of the costs and the employee / patient has 100% coverage for all medical and pharmacy costs the rest of the year. 

Drugmakers are not taking this in stride and are trying new methods to avoid detection. 

Read more here

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Posted on 07/06/2018 7:41 AM by David Moore
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