Daily Insurance Report
Monday 04/19/21 Walt Podgurski 440-773-1108 E-Mail
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Report to Congress - Annual Report on Self-Insured Group Health Plans
Al Stewart, Acting Secretary of Labor / U.S. Department of Labor  / / Read Article

The Patient Protection and Affordable Care Act (Affordable Care Act) (P.L. 111–148) requires the Secretary of Labor to provide Congress with an annual report (Report) containing general information on self-insured employee health benefit plans and financial information regarding employers that sponsor such plans. The Report must use data from the Annual Return/Report of Employee Benefit Plan (Form 5500), which many selfinsured health plans are required to file annually with the Department of Labor (Department). The first Report was provided to Congress in March 2011.1

Approximately 60,500 group health plans filed a Form 5500 for 2018, an increase of nearly 5 percent from the number of plans that filed a Form 5500 for 2017. Of plans that filed a 2018 Form 5500, about 25,500 were self-insured and 4,100 mixed self-insurance with insurance (“mixed-insured”). Self-insured group health plans that filed a Form 5500 covered approximately 35 million participants in 2018 and held assets totaling more than $92 billion. In 2018, there were roughly 28 million participants covered by mixed-insured group health plans that filed a Form 5500; these plans held $135 billion in assets. Table 1 summarizes aggregate statistics for self-insured and mixed-insured group health plans that filed a Form 5500 for 2017 and for 2018.

Anthem, Blackstone, digital health startup K Health launch joint venture to curb costs
Rebecca Pifer / Healthcare Dive / / Read Article

Anthem, digital health startup K Health and Blackstone Growth are launching a joint venture focused on leveraging technology to better triage patient care and lower healthcare costs.
The venture, which has nine figures in funding and is called Hydrogen Health, has been in development for years, the companies said in a Wednesday release. Hydrogen will use K Health's artificial intelligence tools to bring digital health products to the employer and consumer markets.

​Anthem first tapped K Health for its AI technology in 2019, investing tens of millions of dollars in the platform in a bid to better triage care for its more than 40 million members.

K Health's app allows consumers to screen medical needs past an AI trained to ask questions about history, age and gender to address the health concern. The algorithm, which was built by doctors, was trained on millions of medical records to give more accurate results, and — after a short conversation — tells patients how doctors diagnose and treat people with similar conditions and backgrounds.

The symptom checker is free, but a one-time virtual visit with a doctor costs $19, and a membership with unlimited telehealth visits is $9 per month.

K Health has grown steadily since its founding in 2016, raising $271 million in funding to date and growing to a base of 4 million users. Like other digital health startups, K Health saw its growth accelerate during the coronavirus pandemic, with CEO Allon Bloch saying in November the company grew 1,000% over the past year alone.

Voya research shows employees are biased toward HDHPs
By Amanda Schiavo / ebn / / Read Article

Employees have become more focused on their financial health in the wake of the COVID-19 pandemic, however biases towards certain health plans can lead to overspending and negatively impact workers’ financial wellness.

Fifty-nine percent of employees say their finances cause them the most stress, according to research from PwC. With healthcare costs rising twice as fast as incomes, according to research from Voya Financial, employees need more guidance than ever to help them choose the right health plans that will curb overspending and help maintain retirement savings. Overspending on health plans can cost the average employee between $500 and $2,500 more through the year.

New research from Voya shows employees have a bias against HDHPs and the reason for that is as simple as marketing.

“One of the really interesting findings that we saw from the research about why there is that bias comes down to branding, pure and simple,” says Nate Black, vice president of consumer driven health for Voya Financial. “When we replaced the high deductible health plan name and called it something more generic, the share of people choosing high deductible health plans doubled. So just the name itself can have a really significant impact on how people think about what plan they should choose.”

Study Reveals Medicare Supplement Insurance Choices For Those Turning 65
American Association for Medicare Supplement Insurance.   / / Read Article

With the elimination of Medicare Supplement Plan F, the first national study of newly eligible Medigap buyers reveals consumer preferences. Medigap Plan G is the choice of more than half of those turning 65 and purchasing Medicare Supplement insurance reports the American Association for Medicare Supplement Insurance.

More than half of all individuals who first became eligible for Medicare in 2020 and purchased supplemental coverage selected Plan G according a study reported by the American Association for Medicare Supplement Insurance (AAMSI).

"Some 11,000 Americans turn 65 every day which means they must make consequential decisions regarding their Medicare coverage," states Jesse Slome, AAMSI's director. “Available plan choices changed starting in 2020 with the elimination of Plans C and F for new Medicare enrollees." Plan F had previously been the most popular Medigap plan choice for new enrollees.

According to the study the top choice in 2020 was Plan G. "Medicare Plan G has replaced Plan F as the most popular Medigap choice among seniors turning age 65," explains Slome. "It offers great value to those willing to pay a small annual deductible. Plan G provides full coverage for gaps in Medicare such as the hospital deductible, co-pays and coinsurance as well as the 20 percent that Medicare Part B doesn’t cover."

Nearly a third (32.8 %) of buyers selected Plan N the survey found. "Plan N generally has lower premiums that G which makes it an attractive option for many," Slome adds. The survey of several thousand policy buyers was conducted for AAMSI by MedicareFAQ.com a leading national provider of Medicare insurance plans for consumers nationwide.

The American Association for Medicare Supplement Insurance advocates for the importance of insurance protection. To access the latest Medicare insurance statistics, go to www.medicaresupp.org/facts-2021. AAMSI produces the national Medigap industry conference (Chicago, September 8-10, 2021) and makes available a national online directory listing local Medicare insurance agents.

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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

The increase in the uninsured rate in recent years, as well as loss of coverage during the pandemic, has led to attention on the consequences of being uninsured. The need for medical care to test, treat, or prevent COVID-19 has also highlighted the potential consequences of uncompensated care for uninsured people. Uncompensated care costs occur because, although people who are uninsured use less care than people with coverage, most who are uninsured have limited income or resources and cannot afford the high cost of medical care, if and when they do need or use health care.

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.

Tokio Marine to acquire U.S. employee benefits company Standard Security
Buzz Staff / BOLLYINSIDE / / Read Article

Tokio Marine to acquire U.S. employee benefits company Standard Security
The move will also grow Tokio Marine’s footprint in the US, amid several overseas acquisitions that aim to spread the insurer’s risk profile amid a stagnating insurance market in Japan. Reliance Standard Life Insurance, a subsidiary of Tokio Marine-owned Delphi Financial Group, will act as the buyer in the transaction. Standard Security provides employee benefits products such as insurance for paid family leave and disability benefits coverage.

In January, Tokio Marine’s US unit Philadelphia Insurance Companies acquired the staffing insurance business of World Wide Specialty Programs. Another major overseas acquisition on June 2020 saw Tokio Marine buy GCube, a British insurer catering to the renewable energy industry, through its Tokio Marine HCC arm.

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OpenLoop, a platform that connects clinical healthcare workers to telehealth shifts, announced a $3 million seed funding round this week. It was led by an angel group of physicians and joined by Techstars, Next Level Ventures, Panoramic Ventures and ISA Ventures along with existing investors, including Chairman Dr. Richard Ferguson.

Pentegra launches pooled employer plan

Pentegra launched a pooled employer plan that it is marketing through advisers, the record keeper said in a news release.

The PEP — called A Better 401(k) Plan — is being sold primarily through retirement-focused advisers, who are members of the association formed by The 401(k) Plan Company at the end of 2020, Pentegra spokesman Kevin Zimmerman said.

Pentegra launched the PEP on Jan. 1 and recently began efforts to open it up to advisers from outside The 401(k) Plan Company, according to Mr. Zimmerman.

Sixteen advisers from multiple broker-dealers and registered investment adviser firms across the country are already in the process of bringing existing 401(k) plans into Pentegra's pooled plan, Mr. Zimmerman said. He could not immediately determine how many plans had joined the PEP.

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, 04-15-21 - - 
98% of leaders plan to change employee benefits post-pandemic: 5 details

Friday, 04-16-21 - -
WEX agrees to acquire Illinois benefits administration company for $275M

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