Category Archives: Investing and fiduciary requirements

Some Post-PPACA deductibles could be high

 By ALLISON BELL

 Published 4/28/2011 Consumers who buy the minimum required level of health coverage in an Affordable Care Act health care environment could be responsible for handling thousands of dollars of medical costs out of pocket. Analysts at the Henry J. Kaiser Family Foundation, Menlo Park, Calif., come to that conclusion in a report prepared using actuarial analyses from Actuarial Research Corp., Columbia, Md.; the Aon Hewitt of Aon Corp., Chicago (NYSE:AON); and Towers Watson & Company, New York (NYSE:TW). The analysts looked at the deductibles and out-of-pocket spending limits consumers might see if they buy individual health coverage through the new health insurance exchanges that are supposed to come online in 2014. Many Republicans and some Democrats are trying to block implementation of part or all of the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act of 2010 (PPACA). If PPACA takes effect as written and works as supporters have hoped, consumers will be able to use subsidies to buy coverage through the exchanges, which are supposed to help match individual consumers and small employer groups with health insurers. PPACA requires exchanges to offer coverage with 4 levels of actuarial value — bronze, silver, gold, and platinum. The bronze-level plans are supposed to cost the least and cover the smallest share of enrollees’ expenses, and the platinum-level plans are supposed to cost the most and offer the richest level of benefits. When the Congressional Budget Office (CBO) was considering PPACA, it did not provide estimates of exchange plan deductibles or analyses of out-of-pocket cost totals, the Kaiser analysts say. The analysts commissioned the 3 separate deductible and out-of-pocket cost forecasts to deal with variations in estimation techniques and assumptions. The firms found, for example, that an individual who owned a bronze-level plan could end up facing a deductible of anywhere from $2,750 to $6,350 and a coinsurance rate for bills between the deductible amount and the out-of-pocket cost limit ranging from 0% to 30%. The bronze-level plan would cover only 60% of expenses before the out-of-pocket cost limit kicked in. “The variation – which exists in spite of agreement up front among the firms on a common set of major assumptions – is primarily due to differences in the assumed distribution of health expenses across the population, as well as how patients are believed to respond to varying levels of cost-sharing in their use of services,” the Kaiser analysts write. The variation in the estimates suggests that exchange plans could vary widely, despite efforts of the PPACA drafters to promote standardization of coverage terms, the analysts say.

United/Oxford reaches agreement with Stamford Hospital

Highlights:

  • We have reached an agreement with Stamford Hospital. 
  • The new contract takes effective on 5/1/2011 and allows for in network services at Stamford Hospital to continue for our customers without any interruption through February 2014.
  • This agreement applies to all UnitedHealthcare and Oxford commercial products.
  • We will be sending new notices this Friday 4/29/11 to all impacted employers and members who received a precautionary letter on 4/7/11 regarding our potential termination.
  • Copies of the Employer and Member letters are included in the attached.

New Study From Hyatt Legal Plans, A MetLife Company, Helps Illustrate Toll On Workplace Productivity Caused By Employees’ Common Legal Issues

Marcia L. Bowers, Group Sales Director phone: 216.694.4339 or 800.423.0300   NEW YORK, March 22, 2011 – Ordinary personal legal matters – such as will preparation, traffic tickets, real estate matters, debt problems or family situations like adoption and divorce – may be common occurrences, but can take a toll on workplace productivity. A new study, “The Impact of Legal Matters on Today’s Workforce” released today from Hyatt Legal Plans, a MetLife company, found that people with these types of legal issues are spending, on average, close to three hours a week at work dealing with their situation for an average duration of five to six weeks. Furthermore, 37% of men and 47% of women said dealing with their issue negatively impacted their physical or emotional health. The survey was conducted online by Harris Interactive on behalf of Hyatt Legal Plans. Easier with an Attorney The study found that while some people choose to handle a legal issue on their own, either because they feel confident in their ability or because the cost of an attorney is a concern, having legal advice may positively influence someone’s experience. For example, seven in ten individuals surveyed who engaged an attorney said that having legal counsel made them feel more confident and that the issue was easier to resolve. About two-thirds of individuals using a lawyer said that having an attorney gave them peace of mind. Enrollment in a group legal plan through an employee benefits program may positively influence someone’s experience further; those who were enrolled in a group plan and used a network attorney felt more positively about their overall experience than those hiring an independent attorney or those going it alone. “While some people feel confident serving as their own attorney, others do it simply because they are afraid of potential costs. However, there is also an emotional cost of going it alone. Access to a group legal plan through the workplace as a voluntary benefit is an affordable solution for employees. Often for less than $20 a month, group legal plans provide unlimited consultation with an attorney on employees’ most frequent personal legal issues,” said Bill Brooks, CEO, Hyatt Legal Plans. Saving Vacation Days The convenience of having group legal plans as a workplace benefit can not only save money but also time. The Hyatt Legal Plans study found that only 30% of employees accessing their attorney through a group legal plan used vacation or other paid time off addressing their situation, compared with nearly 50% of employees hiring an attorney on their own. Nine out of ten people who used a group legal plan said they would use it again in the future. Interestingly, even 42% of people who were satisfied serving as their own attorney said they would be interested in enrolling in a group legal plan if given the option. “Developing a professional rapport with an attorney is just as important as building a relationship with a family doctor or dentist. Having unlimited, nationwide access to attorneys, along with representation for many key issues, is really appealing to employees. Having a plan available through work helps employees save time and money, while providing peace of mind in knowing that pre-qualified attorneys will take care of them,” added Brooks. Methodology This survey was conducted online within the United States by Harris Interactive on behalf of Hyatt Legal Plans from January 6 to February 7, 2011 among 846 employed U.S. residents ages 18 and older who have had at least one targeted legal issue in the past five years (e.g.foreclosure, adoption, bankruptcy, divorce). This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated. About Hyatt Legal Plans Hyatt Legal Plans, a MetLife subsidiary, is the largest provider of group legal plans in the country, serving more than two million group legal plan members and dependents through a nationwide network of 5,300 law firms. For more information on Hyatt Legal Plans, please visit www.legalplans.com. Group legal plans provided by Hyatt Legal Plans, Inc., Cleveland, OH. In certain states, plans are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, RI. About MetLife MetLife is a subsidiary of MetLife, Inc. (NYSE: MET), a leading global provider of insurance,annuities and employee benefit programs, serving 90 million customers in over 60 countries. Through its subsidiaries and affiliates, MetLife holds leading market positions in the United States, Japan, Latin America, Asia Pacific, Europe and the Middle East. For more information, visit www.metlife.com. About Harris Interactive Harris Interactive is one of the world’s leading custom market research firms, leveraging research, technology, and business acumen to transform relevant insight into actionable foresight. Known widely for the Harris Poll and for pioneering innovative research methodologies, Harris offers expertise in a wide range of industries including healthcare, technology, public affairs, energy, telecommunications, financial services, insurance, media,retail, restaurant, and consumer package goods. Serving clients in over 215 countries and territories through its North American, European, and Asian offices and a network of independent market research firms, Harris specializes in delivering research solutions that help them – and their clients – stay ahead of what’s next.

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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