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.




40% hike for health insurance premiums possible after coronavirus pandemic, Covered California warns
Covered California says there could be up to $251 billion in unexpected costs that commercial insurers will have to account for, and it could be passed to consumers.
Eric Escalante / ABC10

Covered California is sounding an alarm for a potentially drastic premium hike on health insurance across the country due to the coronavirus [COVID-19] impact.

The health insurance marketplace says, due to the pandemic, premiums could increase by 40% nationwide in 2021 without federal help. For comparison, the rate increase for Californians in 2020 was 0.8%.

The findings were released in their national projection of the coronavirus’ impact on people with employer or individual insurance plans, which covers about 170 million Americans.

"Covered California’s analysis shows the impact of COVID-19 will be significant, and that absent federal action, consumers, employers and our entire health care system may be facing unforeseen costs that could exceed $251 billion," said Covered California Executive Director Peter V. Lee. "Consumers will feel these costs through higher out-of-pocket expenses and premiums, as well as the potential of employers dropping coverage or shifting more costs to employees."

While there is uncertainty with cost projections and the coronavirus, the study says one-year projected costs in the commercial market range from $34 billion to $251 billion for testing, treatment, and care related to the virus.



Coronavirus bill will create ‘devastating’ incentive to lay off employees, critics say
Greg Iacurci / CNBC

Coronavirus relief legislation would give jobless workers bigger unemployment checks over a longer period of time.

Self-employed workers, those seeking part-time work, and workers who quit their job or can’t reach their place of work as a result of COVID-19 are among those eligible for benefits.

Payments for some groups, especially lower-wage workers, could even exceed their typical job wages.



Humana expands telehealth benefits … temporarily
By Chris Larson – Reporter / Louisville Business First

Louisville-based Humana Inc. will expand telehealth benefits for its members in an effort to help keep vulnerable seniors safe as they seek medical care during the outbreak of the new coronavirus.

Announced late Monday, the company said the telehealth expansion — which is temporary — applies to its Medicare Advantage, Medicaid and commercial employer-sponsored plans, including self-insured plans.

Humana is temporarily waiving member cost sharing for all telehealth services delivered by in-network providers. This applies to Medicare Advantage members that get telehealth services through Miramar, Florida-based MDLive and to commercial members in Puerto Rico. Commercial members are to seek cost-share-waived telehealth services delivered through San Francisco-based Doctor on Demand.

Humana will temporarily reimburse in-network providers for telehealth visits with at the same rate as in-office visits. To qualify for reimbursement, telehealth visits must meet medical necessity criteria, as well as all applicable coverage guidelines, the release states.

Humana will temporarily accept audio-only telephone visits, which can be submitted and reimbursed as telehealth visits. In-network primary care and specialty providers can deliver care using telehealth service, including behavioral health providers.



Views 7 ways to simplify picking your next employee benefits vendor
By Dave Hulsen / ebn

Selecting a new employee benefits provider is a complex process. When you are working with human resources solutions and technology, there are a lot of eyes on the process, from the CFO to IT and HR ?— so the stakes are high and the pressure is on.

Each step in the process is highly detailed and includes discovering all of the available vendors with an RFI, narrowing down your list, and weighing each option before making the final selection. Not only that, but the process is costly, so picking the right vendor the first time is crucial. Whether you go it alone or enlist the help of an independent advisor, don’t issue your next employee benefits RFP without exploring these seven tips.

1. Define scope and stick to it
2. Prioritize user experience
3. Consider ease of integration
4. Communicate your current state
5. Embrace a collaborative evaluation process
6. Prepare to be transparent
7. Leverage RFP technology