insurance

10 Healthcare Trends to Look For in 2016

It seems the kickoff of a New Year fosters predictions, Top Ten’s, and various and sundry industry-related crystal ball lists. An article about consumer healthcare trends in this morning’s Fiscal Times (10 Healthcare Trends That Will Affect You in 2016) caught my eye. Some of these trends, which we’ve also been following and have highlighted here in the past, are more likely to impact or, perhaps more accurately, continue to impact us in 2016 than others. No break-through revelations; but, all interesting nonetheless.

Quietly Lurking: 2017 Obamacare Waiver Could Open the Door for States to Do Their Own Thing

We’re keeping an eye on it; and, apparently so are many of the states. The healthcare reform law includes a waiver that, starting in 2017, would let states take federal dollars now invested in the implementation of the Affordable Care Act and redirect them and redesign their own health care systems.

Some elements of the law could not be repealed, such as the requirement that insurance companies provide coverage regardless of pre-existing health problems. But they could replace the law’s unpopular mandate that requires virtually everyone in the country to have health insurance, provided the alternative worked reasonably well.

A week-long series of Obamacare…Did you know?

Believe it or not, you can expect the second year of Obamacare to be even more chaotic than the first. Last week we attended a market update meeting related to this year’s open enrollment which begins November 15. The meeting was sponsored by one of the major insurance companies. Any notions we had for a smoother rollout and less disrupted market this year were quickly dispelled. With little more than 6 weeks to the start of open enrollment, it was pretty clear to those of us in attendance that there were still many more questions than answers.

HealthcaredotgovSo, over the next few days, I’m going to provide you with some important “Did you know?” points that I think you need to be aware of. Here’s the first installment:

Did you know…Additional complexities are expected in the enrollment process. Specifically, re-enrollment for those who signed on in the first year, i.e. those who qualified for subsidies in year one must re-qualify. And, more computer glitches are expected. Just yesterday the Wall Street Journal reports that in order to participate in any systems testing, insurance carriers must first agree to confidentiality of the testing process.  Disclosure of testing results is strictly prohibited. There’s essentially a gag order for those carriers. Hmmmm. Color me skeptical but it sure doesn’t foster confidence that things will be improved this year. Also, makes one wonder if keeping it all hush-hush has anything to do with the upcoming mid-term elections.

Read 5 things we need to know before Obamacare enrollment starts again from The Washington Post.

Compliance in the Wild West

I wonder how much time and money employers have spent planning on the various dimensions of the Affordable Care Act (ACA) that died on the vine, have been changed, pushed back or remain so cloudy that no one really knows the correct answers. Do you think it’s enough to buy Las Vegas?

Compliance in the Wild West

I have seen so many changes that the only thing I really know is that the guy who tells you how it is all going to look and has the blueprint on EXACTLY what you should do right now is the guy I will bet against –  in Las Vegas or elsewhere.

So what should you do now about how to plan for the future and ensure you are compliant? That’s a very difficult question to answer. Here is what I think you should do:

  1. Don’t cave to fear mongers who say that prisons will be built all over the country to house ACA non-compliers. Compliance is important but so is having the courage to do the right thing for your employees.
  2. Remain aggressive on finding the best ways to take care of your people in the most cost-effective ways. If something is too edgy or pushes the edge of compliance, dump it. The ACA is a really big law and there is some wiggle room to think creatively.
  3. Any part of the law that is 12 months out may change. Avoid spending time on it now. If a brokerage house is hosting a seminar on a five-year plan, attend only if they are serving a fantastic free lunch.
  4. Keep asking good questions. The ACA rests on the understanding that American employers take good care of their people. Employers are going to be the ones to drive the innovation and provide the clear thinking on this law. If employers cave on providing health insurance solutions (even it is just guidance for their people) then the ACA is doomed. You should demand that everyone work hard thinking through the ACA and finding the best options possible.
  5. We have been deeply immersed in work with insurance advisory boards (of which BBG is a member), TPA experts at ODI and the federal regulators. It is believed among some that there will be an uptick in DOL audits. To that end, we at BBG are compiling all of the items an employer will need to provide. It is not a short list but we know what they will ask for and can step in to help. Our goal is to let you run your business and let us help with the things that you don’t do everyday (like provide cert to the DOL). Who knows if the DOL and other agencies will audit more groups, but if they do we will be ready to help.
Bonus (6).  Don’t worry about this stuff in August. Washington is on vacation, so I don’t think they are!
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