Public vs. Private Health Insurance Exchanges – How are they different?

Health Insurance Exchanges (HIXs) come in two basic flavors:  Public Exchanges and Private Exchanges.  Let’s take a moment to define them and outline the stark differences between the two.

Both types of HIXs were originally created to allow individual people to pick their own health plans from a wide selection of offerings from multiple insurance carriers.  More choice and greater competition are meant to bring the promise of lower rates.
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Nation’s Largest Taft-Hartley Fund Coalition Names KTP Retiree Health Benefit Advisor

NEWPORT, R.I. – March 19, 2013 –The Delaware Valley Health Care Coalition (DVHCC), the largest association of Taft-Hartley funds, labor unions, and government entities in the United States with over two million covered individuals across more than 240 member groups, has selected KTP Advisors as its exclusive vendor on retiree health benefit plans.

Following a competitive process, the Philadelphia-based coalition chose KTP for its expertise on retiree health care and its track record at reducing its clients’ unfunded liability for retiree health care without reducing benefits and increasing retiree costs, said DVHCC officials.

“DVHCC members have been searching for ways to lessen the impact of continuing to offer retiree benefits to their participants. After meeting with several firms offering a variety of services, we selected KTP Advisors. KTP made an outstanding presentation and proposed a solution which best fits the needs of our membership.” explained DVHCC President Matthew Kearney.

“Being chosen as the advisor on retiree health benefits for the DVHCC is an honor,” said Mark Whitcher, CEO of KTP Advisors. “We look forward to working with the individual funds to ensure they receive the best advice and their retirees continue to receive the health benefits they expect at the lowest possible price in the market.”


The Delaware Valley Health Care Coalition (DVHCC), based in Philadelphia, is the largest coalition of Taft-Hartley funds, labor unions, governmental entities and school districts in the United States with over one million covered lives across 245 groups. The purpose of the DVHCC is to provide quality health benefit plans and services at discounted pricing not available to non-Members. For more information on the DVHCC, visit

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Impact of Specialty Pharmacy Programs on Cost and Outcomes for Patients Using Oral Oncology Medications

specialty drugA year-long study published by The American Journal of Pharmacy Beneajpb2fits in 2012,analyzed the results of oral oncology medications on cost and patient outcomes. It concluded that specialty pharmacy programs promoting oral oncology drugs in treatment regiments increased patient adherence and lowered overall medical costs by 13 percent, or about $13,000, in the first year of treatment. According to the study, the savings largely resulted from  a reduction in outpatient hospital costs by more than 40 percent.

Over the past decade oncology treatments have shifted toward increased use of highly targeted oral medications. This has enabled patients to receive treatment at home rather than in an inpatient or outpatient setting.
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Health Group Subsidizing Barnstable

imagesAt the Barnstable Town Council meeting on Oct. 18, Longfellow Benefits, a Boston-based benefits consulting firm, delivered good news in its report to town officials. The town had commissioned the study on whether it could get better health care plans for its employees and retirees by leaving a regional purchasing coalition of neighboring communities. To the surprise of town officials, the report highlighted that the town had received an average of $3.7 million more in benefits in each of the past three years than it paid into the Cape Cod Municipal Health Group, or CCMHG.


Brockton, Massachusetts – A Model for Municipal Reform of Retiree Health Care

stethoscope-squeezing-moneyEfforts to reform municipal health care plans are seen as a political third rail because of resistance to change at many levels. Savings in health care plans typically revolve around shifting costs from a municipality to employees and retirees. There are, however, successful examples of public employee unions and municipalities working together to reduce costs rather than shift a greater percentage to beneficiaries.

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Selling Bonds to Fund OPEB is a Bad Idea

The Michigan Legislature has just passed bill No.1129, which allows municipalities to sell bonds to fund their post-employment benefit obligations. The idea is that in this low interest rate environment municipalities can put aside enough money to cover future obligations for retiree healthcare and reduce the strain on municipal budgets. This well-intentioned law is of dubious value and may be disastrous for Michigan taxpayers in the future.


The law, which does not require voters to approve the issuance of the bonds, requires that prior to issuance a municipality makes available to the public a comprehensive financial plan that includes Section 518 (1) (b) which states: “Evidence that the issuance of the municipal security together with other funds lawfully available will be sufficient to eliminate the unfunded pension liability or the unfunded accrued health care liability.”

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OPEB Liability – Does it Matter?

There is a lot of discussion about OPEB liability and how municipalities can control it. OPEB (Other Post-Employment Benefits) refers to a municipality’s financial obligation to provide retiree healthcare. Most municipalities fund the cost of healthcare benefits for current retirees from the current operating budget. However, many municipalities fail to set aside funds to pay for the benefits promised retirees in the past or future obligations for healthcare benefits promised to current employees when they retire. As a result, unfunded OPEB liabilities grow over time. That funding shortfall is estimated to be in the trillions of dollars when aggregated over the entire country.

GASB 45, the standard issued by the Government Accounting Standards Board on financial reporting of OPEB liability by employers, has done a service to taxpayers by bringing this discussion to the forefront and forcing municipalities to put a number on their balance sheets for this long-term obligation. However, like many well intentioned efforts, this has had some negative, unintended consequences.

What is an OPEB Liability

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