Texas Firm Shakes Up Health Insurance In Utah

Texas Firm Shakes Up Health Insurance In Utah in Group Health Insurance

Since 2005, a Texas company is offering a brand new type of health plan that is different from any traditional coverage available.

The plan covers anything that promotes healthy lifestyles — including massages, acupuncture, and even water purifiers — at a cost as low as $150 a month.

The company providing the plan is the W.I.N. Association, who is based out of Pasadena, Texas.

In Utah, there are a couple dozen members in the self-funded W.I.N. Association Health Plan, reported The Salt Lake Tribune.

But the Utah Insurance Department isn’t too pleased with the new product. They say the plan isn’t licensed to provide health insurance in the state and have gone as far as ordering a cease-and-desist order on the company.

The W.I.N. Association doesn’t have to abide by insurance regulations, argues the company’s owner, Michael Bianchi. He points out that because the W.I.N. plan is an Association Health Plan (AHP), it is not bound by traditional insurance laws.

“If you try to put us in the same box as traditional insurance, it doesn’t work,” said Bianchi.

The W.I.N. plan also differs from regular health insurance because benefits increase every year a member is enrolled.

W.I.N. is currently trying to get a written exemption from the Employee Retirement Income Security Act of 1974 (ERISA) so they can continue business in Utah.

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Health Care Costs Increase At A Slower Rate For Large Employers In Wisconsin

Health Care Costs Increase At A Slower Rate For Large Employers In Wisconsin in Group Health Insurance

For the first time in a decade, the health care costs for large businesses in Wisconsin will increase slower than medical inflation.

Costs will increase by 3.7 percent for this year and medical inflation is just over 4 percent, reported the Milwaukee Journal Sentinel.

The 3.7 increase in costs is quite an achievement for the state’s large companies, considering health care costs increased an average of over 6 percent nationwide.

Towers Perrin, a benefits consulting firm, conducted the employee survey and analysis that found the data for Wisconsin big businesses.

According to their report, the main reasons for the slower cost increase among large employers include higher deductible health insurance plans, wellness programs, and incentives for workers to quit smoking and practice healthier lifestyles.

The Towers Perrin report, however, found that even though health care costs were increasing at a slower rate, the overall costs were still high.

But any health care cost slowdown is definitely a good thing.

“They’ve made a lot of effort to control overall costs, and those efforts are paying off,” said Towers Perrin chief actuary, Dave Osterndorf.

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Bill Would Create Small Businesses Health Insurance Pool

Bill Would Create Small Businesses Health Insurance Pool in Group Health Insurance

Earlier this week, members of Congress introduced a bill in the U.S. House of Representatives that would create let small businesses form nationwide and statewide health insurance pools.

Proponents of such pools argue they give groups more purchasing power to negotiate more affordable rates.

States such as Connecticut and have also considered legislation that would create health insurance pools.

The House bill is sponsored by U.S. Representatives Ron Kind from Wisconsin and Phil English from Pennsylvania, reported CongressDaily and the Kaiser Daily Health Policy Report.

The legislation will also provide small business workers with a tax credit to help them purchase coverage. Individual employees would get $1,000 annually, and families would get $2,000.

While larger businesses can still fit health insurance benefits in their bottom lines, small businesses have trouble doing the same. Many small firms are feeling the pinch of rising health care costs and simply cannot afford insurance.

The small business health insurance pool is one idea, but others are looking other products such as high-deductible coverage and Health Savings Accounts to make insurance more affordable for small companies.

“With rising costs pricing small businesses out of the market, it’s no surprise that 60% of Americans without health insurance are from families where the head of the household is self-employed or works in a small business,” said Representative Kind.

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City Governments In South Carolina To Shake Up Health Insurance Payments

City Governments In South Carolina To Shake Up Health Insurance Payments in Group Health Insurance

When it comes to health insurance benefits for retired city employees, local governments in South Carolina pay them as they need year-to-year. 

Once an employee retires, the city budgets the money right then, explained a lengthy article in the South Carolina State.

But the Government Accounting Standards Board (GASB) in 2004 decided local governments should have the cash on hand to cover the health benefits of every employee if they all retired.

That policy is effective immediately.

The GASB was created in 1984 to impose standards guiding cities on how they should handle the public’s money, wrote the State article.

Unfortunately for many cities, the amount of money needed to cover all employees’ health insurance benefits can reach hundreds of millions of dollars.

If a city or local government doesn’t have the money — and most don’t — the GASB counts the deficit as debt the city has to pay. Starting now, local governments have 30 years to pay off their “debt.”

Why must local governments follow the GASB’s rules?

Standards from the GASB’s standards aren’t technically law, but governments that violate their recommendations can mean higher interest rates from investors who have loaned money — or investors could financially cut them off altogether.

Now, city, county, and other local governments are scrambling to figure out ways to cut costs and pay back their debt.

One solution is to put money in an untouchable trust that invests taxpayer money in the stock market. But local governments aren’t allowed to invest public money into the stock market according to South Carolina’s state Constitution.

The case is going before the state Supreme Court.

“Either way the decision goes, it’s going to affect a large group of people,” said attorney Nancy Bloodgood.

Others are trying to cut costs and save money wherever they can. The Myrtle Beach Budget Director, Mike Shelton, is encouraging retired employees to get certain medical procedures overseas to save money.

Shelton went to Thailand to get a colonoscopy for $700, where it would have been $3,500 in the U.S. Even if the city pays for all the trip’s expenses, even for a little site-seeing, they still save money.

It looks like the whole thing is going to be an ongoing process.

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Utah Businesses Reward Employees For Healthy Living

Utah Businesses Reward Employees For Healthy Living in Group Health Insurance

As health insurance and health care costs continue to skyrocket, businesses and employers are looking for ways to cut costs.

A new trend among some companies in Utah stands to benefit both employers and employees — health and wellness programs.

Nature’s Sunshine Products, who are based in Provo, Utah, rewards workers who can hit health goals — they can earn paid time off and get their health insurance premiums paid for.

In many programs, workers can also get help from “health coaches” to push them to meet their goals.

Usually, you have to actively participate in the health programs to see any benefits. At Nature’s Sunshine Products, employees who don’t set goals or don’t get their health screened have to pay 15 percent of their health plan cost, reported The Salt Lake Tribune.

There is some opposition to such health programs. Critics argue that health monitoring, such as blood pressure and cholesterol readings, are intrusive. Others say they have no time to participate in a health program, wrote the Tribune article.

Even so, businesses that provide health and wellness programs typically find big success.

It doesn’t seem like there’s much harm in offering employees incentives to stay healthy — and save on health insurance.

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San Francisco Restaurant-Goers Paying For Universal Health Care

San Francisco Restaurant-Goers Paying For Universal Health Care in Group Health Insurance

Last September, lawmakers passed Healthy San Francisco, city-wide legislation providing universal health care for every resident. 

The law went into effect on January 9, 2008 requiring any businesses in the city with 20 or more employees to contribute to the Healthy San Francisco program.

Employers have to spend a minimum health insurance, set up health reimbursement accounts for workers, or pay a fee to the city, reported the Los Angeles Times.

It’s driving health care costs up for just about every business — including restaurants.

Some restaurant owners estimate their health care costs will go up hundreds of thousands of dollars in just one year.

Now, many of the city’s most popular restaurants are starting to pass their health care costs on to customers. In one restaurant, a little message at the bottom of the menu reads:

“[Three and a half percent] service charge will be added to all checks for the San Francisco affordable health care legislation.”

Restaurants varied in the method and amount they increased prices for health care. Some are adding up to 4 percent on the entire bill, while others include an additional charge of $1 or $2 for every patron.

“The major players I talked to are all [raising prices]. It’s in the dozens. It’s a scary move, and only the bold are venturing into the territory.” said an owner of an Italian restaurant.

Joan Simon, a restaurant consultant, said the higher prices could also hurt the city’s tourism.

“What drives tourism partially is the reputation San Francisco has for dining. If we make it difficult for restaurants to keep affordable prices… then we’re going to see less tourism,” said Simon.

Will the increase in prices for health care turn away customers? It hasn’t so far.

“We haven’t noticed [the increase in price], so I guess it’s not that big a deal,” said one restaurant customer.

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Aetna To Launch Personalized Health Search Engine for Group Plan Members

Aetna To Launch Personalized Health Search Engine for Group Plan Members in Group Health Insurance

Aetna, one of the nation’s largest health insurers, will soon release a new personalized health search engine for members. The engine, SmartSource, will provide more relevant search results based upon personal health conditions.

SmartSource was created by medical database software developer, Healthline, reported The New York Times. It takes previous records and medical test results to serve more specific answers.

“If your record shows you suffer from sinusitis, a symptom search for ‘headache‘ would tend to favor sinus pain over brain tumors,” wrote the WSJ Health Blog.

The new search software has already been tested by Aetna’s employees, and it’s ready to be rolled out for group plan members.

The tool will be quite interactive — allowing users to look up popular medications for a particular condition, nearby physicians specializing in the searched condition, and information on disease management programs.

Critics question whether SmartSource will actually be effective in providing relevant results. One doctor at the Gartner Group technology consulting firm said the records Aetna and Healthline uses is 15 to 45 days old.

He also pointed out the information gives a limited look into a person’s health profile.

The search tool will also use electronic medical records, which brings up the natural worry of patient privacy.

Aetna and Healthline argue SmartSource won’t save the query results, and it doesn’t know which member is conducting the search.

“We need to develop a relationship with our members based on trust,” said vice president for Aetna’s online programs, Meg McCabe.

They also contend the technology won’t be used to find records and set insurance rates — it’s to help members be more engaged and active in their own health care.

“We make sure the information is secured and shared, based on the member’s purposes,” McCabe added.

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Kentucky Bill Would Expand Health Insurance For Small Businesses

Kentucky Bill Would Expand Health Insurance For Small Businesses in Group Health Insurance

A committee in the Kentucky’s House of Representatives recently approved a bill that would expand help for small businesses to provide health insurance for their employees.

The new bill would make more small businesses eligible to receive ICARE coverage. ICARE is a state-subsidized program that provides health insurance for small businesses with 25 employees or less.

Under the new measure, ICARE would be available for businesses with up to 50 employees, reported the Courier-Journal.

Bill sponsor state Representative Tommy Thompson (not former Wisconsin governor and previous Republican presidential candidate) said the plan would cost the state around $5 to $6 million in the next two years.

“We think [the new bill] is going to allow a lot more people to join the ranks of the insured — if there’s money for it,” said Rep. Thompson.

The bill will now go to the full House for approval.

Small businesses around the country have been hit particularly hard by rising health care and insurance costs. More and more are being priced out of health insurance.

Around 39 percent of small businesses don’t provide coverage for employees, reported USA Today.

Many experts believed Health Savings Account plans would catch wind because of their potential cost-reducing coverage, but they haven’t yet convinced a majority of small businesses.

Kentucky isn’t the only state looking to take action — others are considering laws intended to help cover small business employees.

In the Peach State, lawmakers proposed a Georgia health insurance bill to make HSA plans more attractive for small businesses through tax credits. Also on the federal level, the U.S. Senate is also pondering legislative ways to help small businesses insure their employees.

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Georgia Proposes Health Insurance Bill Aimed at Small Businesses

Georgia Proposes Health Insurance Bill Aimed at Small Businesses in Group Health Insurance

Georgia Governor Sonny Perdue and other state lawmakers recently unveiled a health insurance bill that makes health insurance for small businesses more affordable. The new measure also gives small firms a tax incentive to get employees to enroll in coverage.

Small businesses, 50 or fewer employees, would get a $250 tax credit for every employee that enrolls in a high-deductible health plan (HDHP), reported the Atlanta Business Chronicle.

Plans qualify as a HDHP if the deductible is at least $1,100 for individuals and $2,200 for families.

The Georgia health insurance bill would also allow any resident enrolled in a HDHP to deduct health insurance premiums from their state tax return.

“This is a market based solution focused on empowering individuals and rewarding them for making healthy choices,” said state Senator and author of the bill, Judson Hill.

One nice advantage of a HDHP is the low premiums. For most health plans, when the deductible goes up, the monthly premiums go down.

Many HDHPs also provide coverage for preventive care.

Another feature of a high-deductible plan is the Health Savings Account, or HSA. An HSA lets you take pre-tax income and put it into a savings account to help pay for health care expenses.

Here’s a list of qualified HSA expenses from the Internal Revenue Service, starting on page 5.

“This plan will make affordable health insurance more accessible for the uninsured and working families,” Senator Hill also said.

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Florida Companies Get Strict On Employee Smoking

Florida Companies Get Strict On Employee Smoking in Group Health Insurance

We all know how unhealthy tobacco is, and we know that quitting smoking greatly reduces serious health risks. And we've seen the positive affect of banning smoking in restaurants and public places.

We also know smokers pay more for health insurance and spend much more on health care every year. Businesses also pay more in overall health care costs because of their smoking employees.

That’s why one Florida-based company, Westgate Resort, put in place a policy in 2003 that prohibits employees from smoking altogether.

Now after four years of the smoking ban, the company’s health insurance costs have stayed much lower than other firms, reported the Orlando Sentinel.

While only a couple companies around the U.S. have banned smoking for employees outright, others penalize their workers for the habit. Some businesses are charging employees as much as $100 more a month for health insurance.

The surprise is that many people won’t quit smoking because it’s unhealthy, they only quit for financial reasons.

“We’ve known for a long time that smoking is hazardous to health, and people are still smoking. Education hasn’t worked, cessation programs haven’t worked. You have to make the individual pay for the bad habit.” Becky Cherney, president of the Florida Health Care Coalition.

“People stop for monetary reasons. Why isn’t health enough of a reason?” asked the chief executive of Westgate, David Siegel.

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HSAs Still Not Convincing Small Businesses

HSAs Still Not Convincing Small Businesses in Group Health Insurance

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The Dark Side Of Business Health Insurance Mandates

The Dark Side Of Business Health Insurance Mandates in Group Health Insurance

Many state and federal lawmakers around the country are backing laws that force employers to provide health insurance for their employees or pay a penalty. But all businesses have bottom lines — money spent one place means resources have to be cut in another.

A report conducted by the Employment Policies Institute concluded that laws requiring employers to provide coverage isn’t always the best idea.

“The cost of providing health insurance is so great that most businesses covered by “pay or play” laws will be forced to cut back on hours and jobs just to stay afloat,” said Jill Jenkins, the chief economist at the Employment Policies Institute.

The report also argues that many workers don’t even qualify for the benefits of the laws because they earn too much income. It also points out that employers are forced to lay off workers because of the high costs of health insurance.

So, will health insurance mandates requiring businesses to provide coverage significantly increase the rate of unemployment?

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A Healthier Workforce: Health Coaches For Employees

A Healthier Workforce: Health Coaches For Employees in Group Health Insurance

Employers aren't just penalizing for health risks — many are helping their employees live healthier.

The number of business owners and employers bringing in health coaches to help their employees life healthier is increasing, reported the Orlando Sentinel. These coaching programs allow employees to see a nurse, or "coach," regularly to help them manage health conditions — and get them back in the habit of living a healthy lifestyle.

Some employers, such as financial and banking company BB&T, have been offering health coaching for over 20 years, but it has just recently become more popular.

"[Health coaching] has skyrocketed in the last two to three years," said director of StayWell Health Management, Michael Staufacker. "Coaching has since proved to be a cost-effective way to help many employees make lifestyle-behavior changes.

Sounds like a good idea for employers to offer a health coaching program — especially healthier employees can help slow the yearly 7% (sometimes 8%) rate of health care cost increase among businesses.

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Employers Penalize Workers For Health Risks

Employers Penalize Workers For Health Risks in Group Health Insurance

Here's a new trend to get people to live healthier lifestyles — companies penalizing employees for health risks. Some employers are starting to deduct from paychecks and add insurance surcharges for workers who don’t meet requirements for obesity, blood pressure, and cholesterol levels.

For those who keep track and improve their health can actually receive discounts and rebates for insurance, reported the Associated Press.

"We want more people to participate so that they can take control of their health," said Clarian Health spokesperson, James Wide.

Such a policy raises some controversy, naturally. Some workers are embracing the idea — glad for an incentive to become healthier. One employee of Western & Southern Financial Group lost 54 pounds and has been receiving insurance discounts for over 2 years.

"I knew if I wanted to be healthier and pay less, it was up to me to do something about it," said the 51-year-old.

On the other hand, not everyone agrees. Some believe it's unfair to punish for health conditions. They also contend that the policy invades an employee's privacy.

"I think it's too harsh to charge people for things they can't always control" said one employee who is glad she doesn't work in a company that charges health penalties.

President of the National Business Group on Health, Helen Darling, thinks employers prefer positive incentives rather than penalties. The National Business Group on Health represents over 200 of the largest employers in the U.S.

"I think it's a mistake to use penalties for something as complicated as maintaining weight in a society that does everything to make you inactive," said Darling. "It can make people mad, and we are in a war for talent."

But Ohio-based Scott's Miracle-Gro Company reported 95% of their employees participated in wellness programs and risk assessments after the company instituted health penalties. They charge employees $40 per month for not taking risk assessments and $65 for workers who don't show they're trying to reduce their high health risks.

"We think that personal accountability is a big part of driving overall wellness, but we also provide our associates with the tools they need," said spokesperson for Scott's Miracle-Gro, Jim King.

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Health Insurance Tax Deductions Help Entrepreneurs

Health Insurance Tax Deductions Help Entrepreneurs in Group Health Insurance

Small business owners have long bewailed the rising costs of health insurance for their employees. This has led to some businesses removing health benefits altogether, and suffering because they're not able to attract the talent expecting decent health insurance coverage.
However, recent tax deduction incentives have encouraged some small business owners, and have somewhat eased the pain of increasing health insurance costs.
A recent study, released by the Office of Advocacy of the U.S. Small Business Administration, shows that the health insurance tax deductions for the self-employed has decreased the likelihood of entrepreneurial exit, 10.8 percent for single fliers and 64.9 percent for married fliers.
Affordable health insurance coverage continues to be an important issue for small businesses. It’s encouraging to note that deductions are available to businesses, and that tax initiatives such as these can continue to motivate the entrepreneurial force in the United States.

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