Archive

Archive for the ‘health insurance’ Category

Medical and Prescription Drug Deductibles for Plans Offered in Federally Facilitated and Partnership Marketplaces for 2015

November 26, 2014 Comments off

Medical and Prescription Drug Deductibles for Plans Offered in Federally Facilitated and Partnership Marketplaces for 2015
Source: Kaiser Family Foundation

Most health plans require enrollees to pay a portion of the cost of care when they seek services. While there are lots of forms of cost sharing — deductibles, copayments, coinsurance – people often focus on the deductible amount because it often provides the simplest indication of how generous a plan may be. A deductible is the amount that an enrollee must pay toward the cost of covered services before the plan will start paying for most types of care covered by the plan. Certain preventive services must be covered without cost sharing in all plans in the Affordable Care Act’s Marketplaces, and insurers sometimes pay towards other services, usually physician office visits or prescription drugs, before the enrollee has met his or her deductible. Still, people need to be prepared for the fact that they may need to pay the entire deductible amount out of pocket if they need a significant amount of care during a year.

The slide show provides an initial look at the deductibles for medical care and the specific deductibles applied to prescription drugs for the plans offered in the federally facilitated and partnership Marketplaces available healthcare.gov. The amounts are simple averages of the plans available (see Methods). The amounts are shown separately by metal level (“Bronze,” “Silver,” “Gold,” and “Platinum”). Deductible amounts are shown separately for plans where medical spending and prescription drug spending are both subject to the same deductible (called “combined) and for plans where there are separate deductibles for medical spending and prescription drug spending (called “separate”). Not surprisingly, deductibles tend to decrease as one moves from the levels with lower actuarial values (“Bronze” and “Silver”) to the higher levels.

The slides do not show the deductibles for silver plans that provide reduced cost sharing for people with low incomes (e.g., people receiving cost-sharing subsidies). Many people in Marketplace plans receive these subsidies, and would not be subject to the deductible amounts shown in the slides. We will be releasing a more complete analysis that has information for these plans and for the other types of cost sharing (e.g., copayments, coinsurance amounts) in the near future.

About these ads

Monitoring the Impact of the Affordable Care Act on Employers: Literature Review

November 21, 2014 Comments off

Monitoring the Impact of the Affordable Care Act on Employers: Literature Review
Source: Urban Institute

In this report, we analyze recent trends in the employer health insurance market and the anticipated effects of the Affordable Care Act on employers, with a particular focus on small firms with fewer than 50 workers. We first present a detailed picture of the employer market by identifying preexisting trends in key outcomes that could be incorrectly attributed to the Affordable Care Act. We also analyze the literature to identify economic factors that are important in current employer and employee decisions regarding health coverage.

Map: How Many Americans Could Lose Subsidies If the Supreme Court Rules for the Plaintiffs in King vs. Burwell?

November 20, 2014 Comments off

Map: How Many Americans Could Lose Subsidies If the Supreme Court Rules for the Plaintiffs in King vs. Burwell?
Source: Kaiser Family Foundation

This map based on Foundation analysis of Congressional Budget Office estimates of Marketplace enrollment provides a state-level breakdown of the number of Americans who in 2016 could be denied financial assistance to help pay insurance premiums for plans purchased in the Affordable Care Act’s federally operated insurance exchanges.

Views on the Value of Voluntary Workplace Benefits: Findings from the 2014 Health and Voluntary Workplace Benefits Survey and The Gap Between Expected and Actual Retirement: Evidence From Longitudinal Data (EBRI Notes, November 2014)

November 20, 2014 Comments off

Views on the Value of Voluntary Workplace Benefits: Findings from the 2014 Health and Voluntary Workplace Benefits Survey and The Gap Between Expected and Actual Retirement: Evidence From Longitudinal Data (EBRI Notes, November 2014)
Source: Employee Benefit Research Institute

Executive Summary

Views on the Value of Voluntary Workplace Benefits: Findings from the 2014 Health and Voluntary Workplace Benefits Survey

  • Three-quarters of workers state that the benefits package an employer offers prospective workers is extremely (32 percent) or very (44 percent) important in their decision to accept or reject a job.
  • Nevertheless, 34 percent are only somewhat satisfied with the benefits offered by their current employer, and 22 percent are not satisfied.
  • Eighty-six percent of workers report that employment-based health insurance is extremely or very important, far more than for any other work place benefit.
  • Workers identify lower cost (compared with purchasing benefits on their own) and choice as strong advantages of voluntary benefits. However, they are split with respect to their comfort in having their employer choose their benefits provider, and think the possibility that they may have to pay the full cost of any voluntary benefits is a strong or moderate disadvantage.

The Gap Between Expected and Actual Retirement: Evidence From Longitudinal Data

  • The 2008 economic recession sharply increased the gap between expected and actual retirement. Pre-September 2008, before the investment markets crashed, 83.9 percent of workers retired either earlier or no later than three years after their expected retirement—compared with only 59.3 percent who did so post-September 2008.
  • Longitudinal findings (comparing same cohort at different points in time) show that more people (35.9 percent) actually retired after 65 than expected (18.9 percent), and among those who expected to retire after 65, more than half (56.6 percent) did so. It also shows that 38.0 percent retired before they planned, 48.0 percent retired after they planned, and 14.0 percent retired the year they planned.
  • Longitudinal data also show that people who have a retirement plan tend to retire closer to when they planned, compared with those without a plan. It also found that the gap between expected and actual retirement is generally very small between those with defined benefit plans and defined contribution plans.

Premiums and Stability in the Individual Health Insurance Market: The Effects of Young Adult Enrollment and Subsidies

November 19, 2014 Comments off

Premiums and Stability in the Individual Health Insurance Market: The Effects of Young Adult Enrollment and Subsidies
Source: RAND Corporation

Key Findings

  • Eliminating the Affordable Care Act’s premium tax credits would substantially increase premiums and reduce overall enrollment in the individual market.
  • Reduced enrollment of young adults in the individual health insurance market would lead to modest premium increases.
  • Alternative types of subsidies — such as vouchers — could cause premiums to become more sensitive to the age mix of enrollees.
  • Eliminating the individual mandate would cause small increases in premiums but large declines in enrollment.

See also: Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage

New Commonwealth Fund Report: 21 Percent of Adults with Health Insurance Spent 5 Percent or More of Their Income on Out-of-Pocket Health Care Costs

November 18, 2014 Comments off

New Commonwealth Fund Report: 21 Percent of Adults with Health Insurance Spent 5 Percent or More of Their Income on Out-of-Pocket Health Care Costs
Source: Commonwealth Fund

Twenty-one percent of adults with health insurance spent 5 percent or more of their income on out-of-pocket health care costs over the past year (excluding premiums), and 13 percent spent 10 percent or more, according to a new Commonwealth Fund report. Low-income adults were the most likely to have high out-of-pocket costs, with 41 percent of those making less than $11,490 a year spending 5 percent or more of their income on out-of-pocket health care costs and 31 percent spending 10 percent or more.

The report, Too High A Price: Out-of-Pocket Health Care Costs in the United States, is the first from The Commonwealth Fund’s new survey series tracking whether health insurance plans are protecting their enrollees from high health care costs. The majority of people surveyed had employer-sponsored health insurance, but the sample also included people with Affordable Care Act marketplace plans, individual health insurance, Medicaid, or some other coverage.

U.S. Consumers Believe Bias Trumps Accuracy When Making Medical Decisions, says Accenture Survey

November 17, 2014 Comments off

U.S. Consumers Believe Bias Trumps Accuracy When Making Medical Decisions, says Accenture Survey
Source: Accenture

Don’t expect U.S. consumers to look to health insurers as their primary source of information when they have to make medical decisions, a new survey by Accenture (NYSE:ACN) indicates. The survey of 2,003 U.S. consumers showed the majority (69 percent) of the respondents believe that the information provided by insurers steers them in a preferred direction, and 65 percent believe the information they receive is difficult to apply to their own situation.

Follow

Get every new post delivered to your Inbox.

Join 964 other followers