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Thursday 04/15/21 Walt Podgurski 440-773-1108 E-Mail
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98% of leaders plan to change employee benefits post-pandemic: 5 details
Hannah Mitchell / BECKER'S HOSPITAL REVIEW / / Read Article

Business leaders in charge of employee benefits are altering their offerings, according to research published in an April 7 Harvard Business Review report.

Five survey findings:

Ninety-eight percent of respondents said they plan to newly offer or expand at least one employee benefit.

Eighty-nine percent said they are deprioritizing at least one type of employee benefits due to COVID-19 to prioritize others.

Forty-eight percent of respondents said paid vacation days are getting deprioritized, followed by commuter benefits (40 percent), tuition reimbursement (40 percent), meal vouchers (39 percent) and on-site child care (37 percent).

Sixty-six percent said to combat the attrition from COVID-19, they intend to increase work flexibility benefits, followed by 63 percent who said they plan to increase their child care benefits and 41 percent who said they plan to increase their older adult care offerings.

Forty-one percent of respondents said they plan to expand mental health benefits this year, and 59 percent cited improved mental health as one of the primary outcomes of caregiving benefits.

Patients hit with surprise medical bills paid ER docs 10 times more than others
Samantha Liss / HEALTHCARE DIVE / / Read Article

Dive Brief:

Researchers found that ER doctors retained a larger share of what they initially charged, or what is considered the sticker price, when patients were unexpectedly out-of-network compared to those who were not. Put simply, those physicians retained a larger share of the pie from out-of-network patients.

In fact, patients who likely had a surprise bill ended up paying ER physicians more than 10 times as much as those who did not, according to the report. Patients with likely surprise bills paid on average $151 in out-of-pocket payments compared with roughly $15 for those without.

The incentives for ER doctors differ from other specialties. In general, doctors typically agree to pricing rates with an insurer in exchange for having access to a greater volume of patients in the insurer's network. The idea is that coming in-network guarantees a physician volume. But the same market forces do not apply to ER doctors, who "will not see a reduction in their patient volume if they fail to negotiate contracts with insurers," a report from Yale researchers explained.

This new study adds additional color to this practice: ER doctors stand to collect more in revenue if they stay outside an insurance network.

Consumers In Pain Over High Prescription Prices, Ready To Take Action And In Need Of Better Tools, According To Survey By Scripta Insights
96% of Consumers Are Willing to Make a Prescription Change--Switch Meds, Forms, or Where They Fill--to Save Money
PRNewswire / / Read Article

It's no secret prescription drugs are pricey. So, it's not surprising that "Expensive, Necessary and Cost(ly)" are the first three words that come to mind when people think about prescription drugs. That's according to the results of an online survey released today by Scripta Insights, a cloud-based healthcare IT solution that helps self-insured employers contain their pharmacy benefit spend, while helping members get The Right Meds at the Best Price™.

Scripta Insights released results of an online survey that explores consumers' attitudes and behaviors around prescription drug pricing in America. Scripta is a cloud-based healthcare IT solution that helps self-insured employers contain their pharmacy benefit spend, while helping members get The Right Meds at the Best Price™.

Scripta surveyed 372 respondents, ages 18-60+, in Q1 2021 to delve deeper into American attitudes and behaviors around prescription drug pricing. All respondents have health insurance through their employer and take one or more prescription drugs on a regular monthly basis.

Interestingly, three key themes emerged: there's a hidden culprit for high prescription drug prices, the PBM; the doctor is trusted and a key stakeholder in consumer-directed healthcare; and patients are eager, regardless of household income, to make a prescription change to save as little as $15 monthly.

People are in Pain at the Pharmacy Counter, the PBM Remains the Hidden Culprit

Despite having health insurance, on average, two-thirds of survey respondents (66%) think they pay too much for prescription drugs. Upon further review, that sentiment grows and directly correlates to how much they spend out of pocket monthly: ranging from 45% for those spending under $15, to an alarming 86% for those who spend $50.01 or more.

Vericred Raises $23M in Oversubscribed Series B Funding Round
BUSINESS WIRE / / Read Article

Vericred, the innovative data services platform powering digital quote-to-card experiences in health insurance and benefits, today announced the completion of a Series B round of funding totaling $23 million and the addition of two new members to its board of directors. Aquiline Technology Growth led the oversubscribed funding round, which included participation from new investors Echo Health Ventures, MassMutual Ventures, Guardian Strategic Ventures, and existing investors Riverside Acceleration Capital, FCA Venture Partners and First Health Capital Partners.

Vericred will use the new capital to expand its teams in New York, NY and Omaha, NE, further build its marketing and sales functions, and exponentially grow the community of participants on its market-leading platform, laying the foundation for a united, digitally connected benefits ecosystem.

“Today’s announcement showcases the market’s clear endorsement of Vericred’s critical innovations in health insurance and employee benefits. We are proud to have attracted the highest caliber of venture and strategic investors, surpassing the goals we initially set out for this fundraise,” said Michael W. Levin, CEO and Co-founder of Vericred. “We are excited to partner with these leading investors who share our vision for building a simplified way for all participants in the benefits ecosystem to connect, communicate, and exchange data rapidly and accurately.”

Vericred offers a full suite of APIs across medical, life, dental, vision and other lines of coverage that power quoting, enrollment, member management, and renewals on multi-carrier InsurTech and BenTech platforms. Vericred’s solutions simplify the complex process of exchanging data with multiple partners. By effectively removing a critical barrier to industry-wide digital transformation, Vericred enables a true digital quote-to-card experience.

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Benefit Advisors Network Launches in Canada
By Benefit Advisors Network  / / Read Article

Benefit Advisors Network (BAN), the premiere international network of independent employee benefit firms, is pleased to announce that it has launched in Canada, with Owen & Associates and The Leslie Group becoming the first two firms accepted as members of BAN Canada.

“We are excited to open up our network to the ’best of the best’ employee benefit advisors in Canada and thrilled to have two of the country’s most highly-regarded benefits firms as our founding members,” says Perry Braun, Executive Director, Benefit Advisors Network.

“We see expansion into Canada as an opportunity to provide our neighbors to the north with access to cutting-edge technologies, internationally-recognized experts, and exclusive partnerships that save both time and money while allowing them to strategically grow their businesses,” Braun continues. “Demand for BAN to expand into Canada has been high, particularly given the need for firms to be able to work internationally, so I am confident launching our Canadian brand represents a win-win for both our current members and our new alliances in Canada.”

WEX Signs Definitive Agreement to Acquire benefitexpress
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WEX (NYSE: WEX), a leading financial technology service provider (the “Company”), today announced the signing of an agreement to acquire benefitexpress, a leading provider of highly configurable, cloud-based benefits administration technologies and services. benefitexpress significantly expands WEX’s offerings in benefits administration by adding a complementary suite of solutions to WEX’s Health offerings, including employee enrollment and decision support tools for employees, benefits administration, and important value-added services, such as Affordable Care Act compliance, dependent verification services, and other benefit administration services.

“The acquisition of benefitexpress accelerates our strategic vision of offering a complete healthcare ecosystem with a highly complementary benefits administration platform at its core”

benefitexpress has been a trusted partner of WEX’s Health division for several years. This acquisition will extend WEX’s health and employee benefits products and services across the full, end-to-end needs of employer clients. In addition to making WEX an even more innovative and comprehensive technology and services provider to employers, brokers, and partners, the combined offering will also accelerate opportunities for WEX within the public sector.

Declines in Uncompensated Care Costs for The Uninsured under the ACA and Implications of Recent Growth in the Uninsured Rate
Michael Karpman , Teresa A. Coughlin , and Rachel Garfield / KFF (Kaiser Family Foundation)  / / Read Article

While this analysis finds significant declines in uncompensated care across providers and services following the ACA coverage expansions, the nation still faces sizable uncompensated care costs.

As detailed elsewhere, while providers incur significant costs in caring for the uninsured, the bulk of their costs are compensated through a web of complex funding streams that are financed largely with public dollars. However, these approaches may be inefficient, may not target funds to providers with the most uncompensated care, or may still leave uninsured people with bad debt, credit issues, or even bankruptcy.

Provider charity covers some of the remaining uncompensated care costs, and a very small share, estimated to account for less than one percent of private insurance payments, is potentially covered through cost-shifting to those with private insurance. Even before the pandemic, the uninsured rate in the United States had ticked up in recent years; potential losses of coverage due to pandemic-related job loss could exacerbate these losses and reverse to some extent the significant coverage gains seen since the full implementation of the ACA in 2014.

At the same time, recent efforts – including reopening of ACA enrollment by the Biden Administration and enhanced premium subsidies and new incentives for states to expand Medicaid under the American Rescue Plan – could increase the number of people covered.

Lawsuit accuses BCBS of Massachusetts of systematically allowing overpayments
Morgan Haefner / BECKER'S PAYER ISSUES / / Read Article

A laborers fund in Massachusetts filed a lawsuit against its health insurance administrator, Blue Cross Blue Shield of Massachusetts, claiming the insurer's pricing led to millions of dollars in overpayments to providers.

The Massachusetts Laborers' Health and Welfare Fund filed the lawsuit March 26 against BCBS of Massachusetts in the U.S. District Court of Massachusetts. According to the lawsuit, BCBS of Massachusetts was hired to administer the fund's health insurance services for its self-insured health plan and make benefit determinations on how much the fund should reimburse healthcare providers.

Hybrid workplaces are here to stay—with profound implications for work and society - Three types of workplaces in the new world of work
Deloitte / / Read Article

As we enter the new year, the structure of the workplace will depend on the organization and the work to be done, worker needs and preferences, and the beliefs and behaviors of leaders and colleagues. HR will need to work with business leaders to make decisions at both the strategic and individual worker level—and help the organization navigate those changes effectively. Given the opportunities presented by this year’s challenges, it seems inevitable that the workplaces of tomorrow will lean toward “hybrid” models that include some combination of workers who:

Work onsite at an employer facility
Work remotely / offsite
Work sometimes onsite and sometimes remotely

UConn Health asks for $174M, 3-year bailout from state lawmakers due to ‘unsustainable’ increases in pension, health care costs

Faced with high costs of fringe benefits for state employees, UConn Health is seeking another bailout from the state legislature as it is looking for $54 million, $59 million and $61 million over the next three years.

The money would be used to cover the increased costs for pensions and health care, which are much higher than many other hospitals, officials said.

Photo Of The Day

Monday, 04/12/21 - - Biden's ambitious expansion of long-term care sparks debate

Tuesday, 04/13/21 - -
People are flocking to the reopened Obamacare marketplace — and finding deals

Wednesday, 04-14-21 - - Health care for $1 a month? Covered California touts massive subsidies from COVID relief

Thursday, 04-08-21 - - 
Business Owners Revisiting Employee Benefits to Improve Retention

Friday, 04-09-21 - -
The Pandemic Is Changing Employee Benefits

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.