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Private health exchanges are the hot topic in healthcare right now.  Many large human resource consulting firms have launched their own private exchanges, spurring the potential for biased advice and conflict of interest.

The May 2014 digital edition of Employee Benefit News features Blurred Lines by Andrea Davis.

As employers begin to look at private exchanges as a means to provide health care benefits to their active employee population – 45% of employers surveyed recently by the Private Exchange Evaluation Collaborative said they have implemented or plan to consider using a private exchange for full-time active employees before 2018 –  questions are being raised about potential conflicts of interest for consulting firms that also act as exchange purveyors.

“I think that the private exchanges are rife with conflict of interest, because they’re being mounted by people who are supposedly advising them, and so there are issues there,” says Brian Klepper, president and CEO of the National Business Coalition on Health.

For the full article from EBN, please click here.

Six classes of drugs are presently defined as having ‘protected’ status by the Centers for Medicare & Medicaid Services.  Medicare Part D plans are obligated to cover “all or substantially all” medications within these six classes currently holding protected status.  The Centers for Medicare & Medicaid Services have proposed a rule that would remove designated classes of drugs from protected status.  These drug classes would include antidepressants, antipsychotics and immunosuppressants.  While this may be good news to PBMs, it would without a doubt be bad news for drug manufacturers.

Recently a group of retirees and those approaching retirement answered questions pertaining to financial concerns associated with retirement.  Unsurprisingly, the group of retirees regret not having a better understanding of health care and investments.  As a result, many did not save as much as they could have and are finding it detrimental to their retirement savings.  Falling in line with retirees, the pre-retiree group lacked not only an awareness of health care costs, but also a basic financial plan.
An important, yet often disregarded layer of life after retirement; is simply what will retirees do from day to day?  While some individuals may desire a part time job, many foresee their retirement traveling or enjoying leisure activities.  Regardless of how individuals decide to spend their retirement, it must be calculated for in one’s retirement financial plan.

Read more here: Listen up boomers, retirees have a message for you

On the first of the 2014 calendar year IUPAT District Council 21 (DC 21) appointed KTP Advisors as their Medicare Eligible Retiree Benefit Advisor.  DC 21 stands to save 24% or $667 per retiree per year in transitioning to the fully insured Medicare supplement plan negotiated by KTP Advisors for members of the Delaware Valley Health Care Coalition.  KTP Advisors looks forward to helping DC 21 with continued savings and retiree benefit management support.

Endorsements from IUPAT District Council 21:
The major function of IUPAT District Council 21 Customer Service Team is to be responsive to the needs of our retirees.  Concerns arise when making a change from one carrier to another as transitions can prove difficult.  We were impressed by KTP Advisors’ approach to managing any and all of our questions or concerns.  KTP delivered a seamless implementation process with little disruption to our retirees.  KTP Advisors continues to be approachable, responsive and timely with any requests from our team.  I am confident this level of client service is the standard at KTP Advisors and would recommend their services.

Robyn Simpson
Office Manager
District Council 21 Benefits Office

KTP Advisors assisted IUPAT District Council 21 in moving our Medicare eligible retirees from a self-funded medical plan to a fully insured medical plan.  We are using the Medicare supplement plan that was negotiated by KTP Advisors for all members of the Delaware Valley Health Care Coalition.   This new Medicare supplement plan is saving the trust fund 24% or $317,000.00 per year.  KTP Advisors personnel were very knowledgeable and worked together with our current advisor during the evaluation process.  They were able to implement the new plan on a very tight time table and were very responsive.  I feel very comfortable recommend them to help other plans achieve significant savings.

Michael Previtera
Fund Administrator
District Council 21 Benefits Office

 

The Affordable Care Act (ACA) Employer Mandate has again been delayed for employers with 50 to 99 employees.  Due to the delay, medium-sized employers are not required to offer full time employees health insurance coverage until 2016, two years later than the original mandate was to go into effect.  Employers who fail to offer full time employees coverage face a fine of up to $2,000 per employee.

Read more here: White House delays health insurance mandate for medium-sized employers until 2016

At 2 percent, 2013 marks the lowest Medicare spending growth in 15 years.  2014 is forecasted to continue the low spending grown trend. 

Read more here: Medicare Spending Rose by Just 2 Percent in 2013, CBO says

In a direct and quick response to the Walgreens – AmerisourceBergen – Alliance Boots deal, announced last April, CVS Caremark and Cardinal Health announced a 10-year joint venture for the purpose of bulk purchasing generic prescription drugs (see related CNBC news article).

CVS continues to vertically and horizontally integrate through acquisition (Coram Infusion Services) and vendor partnering (Cardinal) to strengthen its competitive position against Express Scripts and Optum.
Continue reading “CVS Caremark, Cardinal enter 10-year joint venture. Carbon copy of Walgreens, AmerisourceBergen deal. Express Scripts is next.”

There is a lot of hype right now about the Affordable care Act (ACA) and the impact it will have on healthcare.  Less recognized is the impact ACA will have on state and local government’s OPEB liability.  OPEB or ‘other post-employment benefits’ is a massive liability, unlike pensions, one most states and localities have not prefunded.  Every day as healthcare costs rise and Americans continue to age, that OPEB gets bigger.

ACA could be seen to many states and local governments as a solution to their OPEB problem, at least the portion of OPEB attributable to pre-Medicare retirees.  The ACA exchanges will allow these localities to move their pre-65 retirees on to health plans on the ACA exchanges.  But moving these pre-65 retirees to the exchanges will simply transfer costs from the state or local government level to federal taxpayers.

Click here for an excellent and informative related article on this subject in BusinessInsider.com.

To download a copy of this article for your reference, or to share with others, click here.

The European Commission approved the first biosimilar, generic equivalent, of Remicade yesterday. Remicade is an infusion used for many inflammatory conditions such as rheumatoid arthritis and Chron’s disease. Specialty medications are very complex medications and unlike other medications are very difficult to manufacture. The Wall Street Journal announcement is provided below with additional information and for your reference. We will have to wait and see how and when the FDA will address biosimilars here in the US as they work towards final language of the biosimilar legislation.

Click here for related article in Rueters.com.

To download a copy of this article for your reference, or to share with others, click here.

 

Much has been written and discussed about how the Affordable Care Act (ACA) impacts employed and unemployed individuals but what about the retirees?  To examine this question first we must distinguish between Medicare eligible and non-Medicare eligible retirees.

Medicare eligible individuals (typically those age 65 and older) enrolled in either original Medicare or a Medicare Advantage plan satisfy the individual mandate of the ACA by having that coverage.  The employer mandate of the ACA does not apply to Medicare eligible retirees.  So with the exception of some smaller requirements, the ACA does not apply to Medicare retirees.
Continue reading “Does Health Care Reform Impact Retirees? Yes!”