$19,616 — that’s the average cost nationwide of an employer-provided family health plan in 2018 according to recent employer study conducted by the nonprofit Kaiser Family Foundation and reported in today’s Wall Street Journal. It’s pretty staggering to think about the fact that $19,616 is only the average and that there are more than a few folks across the country paying a lot more than the average.
The dirty little secret that’s fast becoming less of a secret is that hospitals charge health plans anywhere from 2 to 5 times more for hospital services than they charge Medicare.
Health Insurance Multiple Choice Question
Per the WSJ article, a “major driver of employer premium growth over the years has been the prices that insurers and employers pay for health care”.
For several years now, and possibly even more so today, the increasing prices for hospital-related services and hospital stays have been the major cost driver of insurance premiums for private insurance coverage. The prime drivers for the hospital price hikes include hospital pricing for emergency-room visits, surgical hospital admissions and administered drugs.
Hospital pricing is especially crazy. This is particularly true as it relates to the health plans that employers provide to the approximately 150+ million Americans that rely on employer-sponsored health plan coverage. The dirty little secret that’s fast becoming less of a secret is that hospitals charge health plans anywhere from 2 to 5 times more for hospital services than they charge Medicare.
We’ll be reporting more about this conundrum that is hospital pricing and what’s being done to combat or rein in the crazy pricing in upcoming posts.
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- Tom Barrett
- October 4, 2018
- confusion, cost, costs, employees, employers, health plans, healthcare, hospitals, insurance, kaiser, kff, medicare, survey, trends
- 0 Comments
The “Controlled Group” question is popping up for many employers with much greater frequency as part of various and sundry regulatory applications, audits, surveys, reporting requirements and underwriting questionnaires.
Netting it out in layman’s terms — at least as it relates to health insurance and ACA compliance — a controlled group may exist when multiple companies fall under common ownership.
The ACA includes a provision under which companies that have a common owner (or are otherwise generally related) are combined and treated as a single employer for purposes of determining if the companies collectively employ at least 50 FTEs (the combo of full-time EEs and full-time equivalent EEs).
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- Tom Barrett
- July 29, 2016
- ACA, affordable care act, coverage, employees, employers, federal, health plans, healthcare, healthcare reform, insurance, medical, Obamacare, penalties, ruling, survey
- 0 Comments
Seems like everyone wants to know what’s on the minds of employers and what they are thinking about insurance. A new survey conducted by Wells Fargo Insurance interviewed 70 employers across the U.S. Results show that as employers and their employees face higher costs, deductibles and copays the employers are searching for ways to control costs and help employees improve their health.
The survey findings also show the top three employer product innovations this year include:
- Accountable Care Organizations (ACO’s)
- increased wellness programs
- narrow provider network offerings
47% of survey respondents say they will develop their own private proprietary exchange by 2015.
Read the full article at Wall Street Journal online, Survey: Cost of Healthcare Claims Continue to Rise; Interest in Private Exchanges Increases
Are you an employer? What are you thinking about insurance?
We’re often asked by clients and colleagues about how their health coverage (and related costs) stacks up against the averages. Kaiser Family Foundation (KFF) recently released the results of their Annual Employer Health Benefits Survey. Among the findings:
- Employer-sponsored insurance covers about 149 million nonelderly people.
- In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage.
- There is significant variation around the average single and family premiums, resulting from differences in benefits, cost sharing, covered populations, and geographical location.
- 21% of covered workers are in plans with an annual total premium for family coverage of at least $19,622 (120% of the average family premium).
- 21% of covered workers are in plans where the family premium is less than $13,081 (80% of the average family premium).
- Over the last 10 years, the average premium for family coverage has increased 80%.
- 57% of firms offer health benefits to their workers.
- 45% of employers with 3 to 9 workers offer coverage, but virtually all employers with 1,000 or more workers offer coverage to at least some of their employees.
The complete results and analysis of KFF’s Employer Health Benefit Survey can be found at http://kff.org/private-insurance/report/2013-employer-health-benefits/