Posts tagged "health care"

Pay a Higher Deductible or a Higher Premium?

May 11, 2018 Posted by health insurance 0 thoughts on “Pay a Higher Deductible or a Higher Premium?”

It’s the ultimate insurance debate: pay a higher deductible or higher premium? With many employers looking for ways to cut costs, the question to increase your monthly health insurance premiums or to pay a higher deductible is a concern you may be facing sooner rather than later.

First, let’s clarify the difference between a premium and a deductible.

  • A premium is the amount of money charged by your insurance company for the plan you’ve chosen. It is usually paid on a monthly basis, but can be billed a number of ways. You must pay your premium to keep your coverage active, regardless of whether you use it or not.
  • A deductible is a set amount you have to pay every year toward your medical bills before your insurance company starts paying. It varies by plan and some plans don’t have a deductible.

In 2017, more employers than ever included a high-deductible option on their 2017 menu of health plan offerings. An August survey of 600 U.S. companies by benefits consultancy Willis Towers Watson found that by 2018, nearly half will offer these plans exclusively. In 2006, high-deductible plans covered just 3 percent of workers. Fast-forward to 2016, and that figure was 29 percent, benefits consultancy Mercer found.

High Deductible Health Plans (HDHPs): Pros and Cons

HDHPs work differently than traditional POS (Point of Service) or PPO (Preferred Provider Organization) plans in that all healthcare expenses are paid out-of-pocket until the deductible is met. The concern with high deductibles is that it causes patients to not seek medical treatment because they fear the expense. Ultimately, this causes more extensive issues later on, such as those relating to diabetes, hypertension, depression, even cancer.

HDHP Pros:

  • Premiums are typically lower than with POS or PPO plans
  • Networks are not necessarily narrowed, as with HMOs
  • People who rarely use their health benefits may save money
  • If you are not on expensive medications, your monthly bills may be lower
  • Out-of-pocket expenses are not the market rate, but the negotiated rate between the healthcare provider and insurance company
  • Policyholders can open a health savings account (HSA), which never “expires,” to help cover out-of-pocket expenses

HDHP Cons:

  • People managing chronic illnesses find that their out-of-pocket expenses are high
  • Prescriptions, office visits, and diagnostic tests are completely out-of-pocket until you reach your deductible
  • If you need surgery, you will need to hit your deductible before the insurance company will pay anything
  • If your monthly out-of-pocket expenses are high, you aren’t taking full advantage of your HSA
  • Your deductible can be quite high (sometimes as much as $13,000 for families)

Those who initially lean toward higher insurance premiums are usually looking to save money in the long run, while those who originally gravitate to the higher deductible plans are looking to put more money in their pockets right now. However, sometimes it’s not that simple.

A 2011 study by the Kaiser Family Foundation found American families are increasingly paying more and more out of pocket for their health care costs – a whopping $15,073 for a family health insurance plan. However, it’s unlikely you’ll pay that full amount. With most employer-sponsored health care plans, your company pays a hefty dose of the premiums.

The Bureau of Labor Statistics reports that in 2008, private sector companies paid as much as 71 percent of family health insurance premiums. Public sector employers dished out even more – up to 73 percent.

While a high deductible plan and its subsequent lower premiums can put more money in your pocket, as well as your employer’s pocket, right now, it isn’t always the best choice. The Kaiser Family Foundation study also determined that the average deductible on these consumer-driven plans was nearly double that of traditional health insurance. On top of that, plans with a high deductible often come with a higher out-of-pocket max as well, sometimes as high as $10,000 a year for a family insurance plan.

Which plan is right for you?

As health insurance is not a one-size fits all item anymore, each person has to weigh the pros and cons of high deductible health plans against how they might need to use the policy. A person without an extensive medical history and unmarried without children might be able to risk such a plan. However, if an individual or someone in the  family sees a doctor once a month or needs to manage a medical or mental condition, perhaps a PPO would be a better.

Ultimately, choosing the right plan for you and your family can seem like you’re gambling with both your health and your money. If you are unsure of the insurance plan your company is offering you, a licensed insurance agent can assist you in finding a plan directly from the best health insurers.

Amazon, Berkshire Hathaway, and JPMorgan Chase to partner on US employee health care

January 30, 2018 Posted by health insurance, news 0 thoughts on “Amazon, Berkshire Hathaway, and JPMorgan Chase to partner on US employee health care”

Amazon, Berkshire Hathaway, and JPMorgan Chase on Tuesday announced plans to partner on ways to cut health-care costs and improve services for their U.S. employees. The announcement slammed the shares of multiple companies in the health-care sector.

Together, the three companies employ more than 1.1 million workers.

The three massive companies will launch an independent outfit initially targeting technology solutions, with the intention to be an umbrella firm that would be “free from profit-making incentives.”

Details of the new company were sketchy, with principles of each firm noting that the way it will work remains to be seen. They’re hoping that the sheer size of each firm will help bring the necessary scale and resources to tackle the issue.

“The ballooning costs of healthcare act as a hungry tapeworm on the American economy,” Berkshire CEO Warren Buffett said in a statement. “Our group does not come to this problem with answers. But we also do not accept it as inevitable. Rather, we share the belief that putting our collective resources behind the country’s best talent can, in time, check the rise in health costs while concurrently enhancing patient satisfaction and outcomes.”

Three top executives, one from each company, will take the lead on the project: Investment officer Todd Combs at Berkshire, Marvelle Sullivan Berchtold at J.P. Morgan, and Beth Galetti, a senior vice president at Amazon.

Combs was a hedge fund manager before joining Berkshire in 2010. Berchtold was previously global head of mergers and acquisitions at drugmaker Novartis before joining J.P. Morgan last year, and Galetti served as FedEx’s vice president for planning, engineering and operations before joining Amazon in 2013, according to their LinkedIn profiles.

“The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” said Amazon CEO Jeff Bezos. “Hard as it might be, reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”

“Our people want transparency, knowledge and control when it comes to managing their healthcare,” said JPMorgan Chase CEO Jamie Dimon. “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”

The new company’s goal at first will be to target technology solutions to simplify the health-care system.

“I think it is good news,” Allergan CEO Brent Saunders told CNBC. “The health-care delivery system is antiquated and in dire need of positive disruption. My hope is these three companies light the spark!”

Adam Fein, president of Pembroke Consulting, said it’s “long past time” for employers like these three to force innovation into the health-care system.

“For better or worse, there are warped incentives baked into every aspect of the U.S. health-care system, from medical innovation to care delivery to insurance and benefit management,” Fein told CNBC. “Rather than merely bashing the current system, I hope this new organization can help patients and their physicians make more informed and more cost-effective decisions. Technology will be necessary but not sufficient to make positive changes.”

Analysts echoed the sentiment that the health-care system is outdated and ripe for disruption, paving the way for the new endeavor. However, they cautioned it could take time.

“If this winds up being the low cost provider to make insurance more affordable at employer level, it could wind up being a real disruptive competitor to an industry that has not seen any new players in years/decades,” Jefferies analyst Jared Holz told CNBC. “Not going to call this black swan event yet because there are few details and would be making too many assumptions but it has potential to be.”

Leerink Partners’ Ana Gupte said the comments suggest the leaders view the endeavor as one that’s “complex, challenging and thorny and that will take time to bear fruit.”

Shares of each company were little changed in premarket trading.

However, shares of other leaders in the industry fell sharply. CVS and UnitedHealth each were off about 7 percent in premarket trading and ExpressScripts fell nearly 8 percent and Aetna was down about 3 percent.

Source: Amazon, Berkshire Hathaway, and JPMorgan Chase to partner on US employee health care

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