Medicare Supplement Enrollment Reaches Nearly 12 Million

As of December 31, Medicare supplement plans covered over 11.9 million seniors, a 6.5% increase from 2014. The study by Mark Farrah Associates reveals that enrollment in Medicare supplement plans increased by 729,495 covered lives from 2014 to 2015. UnitedHealth is the industry leader, commanding about 39% of the market growth, but several other Medicare supplement carriers also experienced membership gains in 2015.

More than 5 million new Medigap policies were issued in the past three years. Plan F accounted for 55% of the market in 2015, which covers Medicare deductibles and coinsurance and copayment costs. Carriers are selling products at competitive rates while maintaining favorable loss-ratios. The aggregate loss ratio was 77.5% (incurred claims as a percentage of earned premiums). With about 55 million Medicare eligibles, more insurers are diversifying their senior market portfolios

Employees Are in the Dark About Disability Coverage

Workplace enrollment in disability coverage lags behind other types of coverage, according to a study by Lincoln Financial. Only 30% of employees say they know a lot about disability insurance. Ninety-five percent say they are more likely to enroll in benefits that they are familiar with and educated about.

Sixty-seven percent of employees who are offered disability insurance enroll; 81% enroll in life insurance; and 90% enroll in dental insurance. The one-third of employees who don’t enroll in disability coverage say that it’s unnecessary right now. However, just 18% are very confident that they could cover expenses if they experienced a serious illness or injury. About half of American employees say cancer is their top health concern.

Eric Reisenwitz of Lincoln Financial said, “Disability insurance can seem abstract. Many don’t fully understand the protection it can provide. But the ability to earn an income is often the primary source of financial security for an individual or family. We insure our homes, our cars, and ourselves. Why wouldn’t we insure our income? Employees need more education to truly get the most of benefits offered through the workplace, May is Disability Insurance Awareness Month — an excellent time to help employees understand the value of this coverage, which is often right at their fingertips.”

CBO updates ACA cost projections

Over the next 10 years, the Affordable Care Act will cost $1.34 trillion, according to the Congressional Budget Office, up 11% from projections a year ago, mostly because of higher-than-expected enrollment in Medicaid. The law gave 22 million people access to coverage they otherwise would not have had, the report found, and the cost of providing that coverage from 2016 to 2019 will be $465 billion, 25% less than projected when the law was passed. The New York Times (free-article access for SmartBrief readers) (3/24), San Francisco Chronicle (free content)/The Associated Press (3/24)

HHS to require proof of eligibility for late health plan enrollment

People who want to use HealthCare.gov to subscribe to a health insurance plan or change plans outside the open enrollment period must now prove that they are eligible, marketplace CEO Kevin Counihan said. The requirement is “a much-needed step in the right direction,” said AHIP spokeswoman Clare Krusing. The New York Times (free-article access for SmartBrief readers) (2/24)

Calif. exchange officials seek tighter enrollment rules

The Covered California health insurance exchange board of directors is expected to vote in April on proposed rules that would require consumers to provide documentation of eligibility for enrolling in a health plan outside the open enrollment period. California Healthline (2/19)

Enrollment Figures Show Robust Interest in Health and Dental Coverage through Covered California

Covered California is seeing very strong interest in the new optional dental coverage offered for adults through the health exchange. More than 33,000 people enrolled in family dental coverage since Covered California members began renewing their health insurance plans on Oct. 12. “We have been surprised by the extraordinarily high enrollment,” said Covered California executive director Peter V. Lee.As of Nov. 17, approximately 6,000 new enrollees purchased a family dental plan at the time of enrollment. In addition, more than 27,000 members had chosen to purchase a family dental plan at the time of renewal.

This year, Covered California makes it possible for consumers to purchase optional dental coverage for 2016 as an add-on to the health coverage they purchase through the exchange. Pediatric dental benefits for members under 19 years of age continue to be included with health coverage.

The family dental plan offers adults the option of receiving dental coverage outside of the general health plans at an additional cost. Unlike premiums for health coverage, premiums for dental coverage through a family dental plan are not subsidized through Covered California, but dental plans offered through the exchange are actively purchased and must be offered on a guaranteed issue basis — meaning the coverage is available to anyone who wants it regardless of any pre-existing dental health conditions. Open enrollment for health insurance coverage and for the new 2016 dental coverage for adults began on Nov. 1 and will continue through Jan. 31.

Covered California is offering dental health maintenance organization (DHMO) and dental preferred provider organization (DPPO) plans. There is no financial assistance available for the optional family dental plans, and there is no tax penalty for choosing not to enroll.

How the ACA Is Shaping Benefit Plans

The Affordable Care Act (ACA) is driving three trends in the workplace: increased outsourcing; reliance on private exchanges; and consideration of self-insurance. The study by the Guardian also finds that 60% of employers need guidance on managing their responsibilities under the Affordable Care Act (ACA).

Employers need help with new administrative and compliance requirements. They also need help with offering employees benefit choices and enhancing the enrollment experience while controlling costs and funding. Sixty-one percent of employers say that preparing for a post-healthcare reform era is a highly important benefit objective, but only 40% say they are prepared to meet this objective. Ray Marra of the Guardian said, “Brokers and carriers are needed to play a strategic role in helping employers navigate the ACA and in identifying the best options for how they can move forward in a changed benefit landscape. As employers adapt to the ACA, we’re seeing greater adoption of private exchanges and self-funded medical plans paired with stop loss insurance.”

One in three employers expects to outsource more aspects of their benefit program as a result of the ACA. Nearly 70% of employers expect compliance and administrative burdens to grow. About 20% of employers expect to offer benefits on a private exchange in the next year. Top reasons are to increase employee choice and to improve the employee experience. Fifty-eight percent those who are thinking of self-insuring say that the ACA is the impetus. Half of those planning to self-insure expect to carry stop-loss insurance. Self-insuring medical plans is a less common funding option for smaller firms, but it’s getting more attention due to the ACA. Seventy-eight percent of employers expect benefit cost increases, due to the ACA

ACA Enrollment Trends

ACA Enrollment Trends
The ACA has had a substantial effect on health insurance enrollment, product mix, and company focus over the past 18 months, according to a report by Mark Farrah Associates (MFA). MFA focused on the fourth quarter of 2013 to the second quarter of 2015. The survey reveals the following:

  • Blue plans gained over 2.3 million commercial members from the fourth quarter of 2013 to the second quarter of 2015.
  • Commercial enrollment for non-Blue plans dropped .3%. Medicare membership increased for Blue plans and non-Blue plans.
  • Non-Blue plans increased their Medicare membership by 35.9% from December 2013 to June 2015 while the Blues saw a 13.3% decline.
  • Medicaid membership experienced the largest gains. As of June 2015, CMS reported 71.9 million Medicaid members, an increase of 13.1 million, since October 2013. For June 30, 2015, health insurance companies that file NAIC statutory statements reported Medicaid membership of 43.8 million, up 13.8 million, since December 2013. It is important to note Medicaid plans that are not regulated by state insurance departments generally account for differences between NAIC and CMS reporting.
  • The top five leaders with Medicaid business include Anthem, UnitedHealth, Centene, Molina, and WellCare. Collectively, they added approximately 5.8 million members to their books, accounting for a 44% share of the growth in Medicaid enrollment over the 18-month period. Anthem had the greatest change in product mix with a shift toward Medicaid. As of June 2015, its Medicaid mix was 15.4%, up from 11.8% at the end of 2013.

Medicare Advantage Premiums Remain Stable; Enrollment at All-Time High

The Centers for Medicare & Medicaid Services (CMS) announced that Medicare Advantage premiums will remain stable and more enrollees will have access to higher quality plans while enrollment is projected to increase to an all-time high. In addition, CMS released today new information that shows that millions of seniors and people with disabilities with Medicare continue to enjoy prescription drug discounts and affordable benefits as a result of the Affordable Care Act. Today’s announcement comes as CMS releases the premiums and costs for Medicare health and drug plans for the 2016 calendar year.

CMS estimates that the average Medicare Advantage premium will decrease by $0.31 next year, from $32.91, on average, in 2015 to $32.60 in 2016. Fifty-nine percent of Medicare Advantage enrollees will face no premium increase.

Sean Cavanaugh of CMS said, “Seniors and people with disabilities continue to experience stable premiums in Medicare health and drug plans while benefiting from a transparent and competitive marketplace. Medicare Advantage and prescription drug plans remain affordable and provide high quality care.”

Access to the Medicare Advantage program will remain strong, with 99% of beneficiaries having access to a plan. In addition, in 2016, more Medicare Advantage plans will offer supplemental benefits for enrollees, such as dental, vision, and hearing benefits. From 2010, when the Affordable Care Act was enacted, and 2016, premiums are expected to decrease by nearly 10% and enrollment is projected to increase by more than 50% to approximately 17.4 million enrollees, which is about 32% of the Medicare population. At the same time, beneficiaries are receiving higher quality care. About 65% of Medicare Advantage enrollees are enrolled in plans with four or more stars for 2016, a significant increase from 17% of enrollees in such plans in 2009.

Premiums in the Medicare Prescription Drug Program (Part D) will also be stable next year. Earlier this year, CMS announced that the average basic Medicare prescription drug plan premium in 2016 is projected to remain stable at $32.50 per month. Because of the Affordable Care Act, people with Medicare are seeing reduced costs through savings on covered brand-name and generic drugs and access to certain preventive services at no cost sharing. Since the passage of the Affordable Care Act, which closes the prescription drug donut hole over time, more than 9.8 million people with Medicare have saved over $17.6 billion on prescription drugs through July 2015 as a result of the discounts in the donut hole and rebates in 2010, for an average of $1,796 per beneficiary.

Quality in Part D continues to be strong, with close to 50% of prescription drug plans receiving four or more stars. These plans serve about one-third of prescription drug plan enrollees, compared to 27% of enrollees in plans with four or more stars in 2009. CMS calculates star ratings from one to five (with five being the best) based on quality and performance for Medicare health and drug plans to help beneficiaries, their families, and caregivers compare plans.

The annual election period for Medicare health and drug plans begins on October 15, 2015 and ends December 7, 2015. Plan costs and covered benefits can change from year-to-year

New Tools Make It Easier to Save for Retirement

Employee contribution rates and account balances have gotten a boost from enhanced offerings that make it easier to save for retirement, according to a Deloitte survey. Plan sponsors and providers have expanded offerings to include automatic enrollment, step-up contributions, individual financial counseling, and mobile transaction processing. The number of plans offering step-up contributions increased substantially from 46% last year to 62% in 2015. Mobile transaction processing is available in 59% of plans (up from 52% in 2013 to 2014 and 25% in 2012.) This year’s survey was conducted with the International Foundation of Employee Benefit Plans and the International Society of Certified Employee Benefit Specialists.

Forty percent of plan sponsors said that the number one reason for employees give for participating in retirement plans this year is to save for retirement, surpassing last year’s top reason of taking advantage of the company match. Only 19% of plan sponsors expect most employees to be ready for retirement. Average account balances of participants grew in 2015 to $99,011, up almost 4% from $95,227 in 2013 to 2014. Employee contribution rates also increased. The median actual deferral percentage for non-highly compensated employees rose to 5.9%, a 13% increase over last year.

Plan sponsors and providers are using multiple tactics to encourage retirement savings and raise awareness of the income needed in retirement. The highest rated approaches are general and multiple communications/education at 83% (up from 73% in 2013 to 2014), followed by targeted communications at 68%, up from 56% in 2013 to 2014. Group meetings remained in the top three at 66%, up from 60% in 2013 to 2014.

Ninety-four percent of plan sponsors are offering some form of matching or profit-sharing contribution in their defined contribution plans, with 6% increasing the match. For the first time in five surveys dating back to 2009, 100% of respondent plan sponsors with discretionary matching made the matching contributions.

Last Updated 10/28/2020

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