Price Waterhouse Coopers annual medical costs trends report suggests that a 9 percent increase in health insurance coverage will occur in 2010. This 9 percent increase is primarily for businesses and their employer sponsored health plans. Though employers may suffer a 9 percent cost increase in health insurance coverage, employees might have to cope with an even larger increase in coverage.

PWC implies that some of the reasons for this increase in costs is due to employees being concerned about losing their jobs therefore using their health insurance as much as possible while it is still available to them. Another reason for this increase is increasing medical costs as employment rises. More and more uninsured people are turning to Medicaid causing health coverage costs to rise.

A survey done by PWC that involved over 500 employers concluded that 42 percent will increase health care costs for employees in the form of higher premiums, deductibles, and copays.

“As the economy recovers, employers will refocus on more sustainable longer term approaches to medical cost containment based on an increasingly shared interest between employers and their workers,” says Price Waterhouse Coopers Principal Michael Thompson.

Check out the U.S. News article at http://health.usnews.com/articles/health/healthday/2009/06/18/health-highlights-june–18–2009.html

The IRS has released on June 1 the 2010 annual limits or high deductible health plans (HDHP) and health savings accounts (HSA). Under Code Section 223, the new limits are effective for the calendar year 2010. The IRS released the increase on June 1 to allow time for employers, employees, and plan administrators to make adjustments to their plans.

For high deductible health plans (HDHP), the deductible is increasing from $1,150 to $1,200 for individuals and $2,300 to $2,400 for families. The HDHP Maximum Out-of-pocket amount is increasing from $5,800 to $5,950 for individuals and from $11,600 to $11,900 for families.

As for the HSA Statutory Contribution amount, it is increasing from $3,000 to $3,050 for individuals and from $5,950 to $6,150 for families. The catch-up contributions for individuals 55 or older are staying at $1,000.

Beginning July 1, a new law in South Dakota will expand the South Dakota High Risk Pool to children with preexisting conditions that may not be able to get coverage any other way.

The law will help to cover approximately 455 children that are under the age of 19 who are considered medically uninsurable.  Governor Mike Rounds explains that “Every child in South Dakota should have health insurance, and now every child can. The South Dakota High Risk Pool will begin taking applications today for children who have been without health care coverage.”

The open enrollment period is from July 1 through August 29 and allows any child who has been without health insurance coverage for 12 months or longer can enroll without a pre-existing condition waiting period. Other requirements include:

Younger than 19
U.S. citizens
South Dakota residents

Monthly premiums range from $125 to $240 a month for children who qualify for the South Dakota Risk Pool. Deductibles range from $1,000 to $10,000 a year.

Though 455 children does not seem like a lot, especially compared to the 200,000 uninsured children in the state of South Dakota, but it’s a start and South Dakota is definitely making a positive stand for uninsured children.

Everyone nowadays is aware that the Gardasil vaccine administered widely to young girls can protect against four strains of the human papillomavirus, a sexually-transmitted disease which can lead to cervical cancer. But what about older women? A new study argues the vaccine is indeed effective in protecting women ages 24 to 45 from HPV.

About 3 out of 4 sexually active women get HPV at some point in their lives. Though there are more than 100 HPV strains , most are harmless and disappear on their own without treatment. Gardasil protects against four of the strains of the virus that, when untreated, do bear serious medical risks: two which cause genital warts (strains 6 and 11) and two which can lead to cervical cancer (strains 16 and 18). Gardasil is only approved for girls ages 9 to 24, but a rising population of older women (24 to 45) are at risk of HPV infection. This is because more and more women are reentering the dating scene in middle age after a period of monogamy, such as after a divorce.

The ongoing multicenter, parallel, randomized, controlled, double-blind study tested the immunogenicity, safety, and efficacy of the quadrivalent HPV vaccine in 3819 Colombian women ages 24 to 45, none of whom had a history of genital warts or cervical disease. 1911 women received the vaccine, and the other 1908 were given a placebo. The researchers found that among the per protocol population (3222 women), the vaccine had a 90.5% efficacy rate against all strains of the virus. There were only 4 instances of infection in the vaccine group compared with 41 in the control group. The vaccine had an 83.1% efficacy rate against the two most common strains (HPV 16 and 18). Only four cases appeared in the vaccine group versus 23 in the control group. Researchers also looked at the intention-to-treat population, which included women who had not received all 3 installments of the vaccine or who did have a pre-existing HPV infection. When these subjects were included in the calculations, vaccine efficacy against all 4 types of HPV was 31%; against strains 16 and 18 was 24%. Because Gardasil will not protect women who were infected by HPV before they received the vaccine, the lower efficacy in the above mixed population suggests the “public health effect of vaccinating women ages 25 to 45 will be smaller than that recorded after vaccinating susceptible adolescents,” said researchers. Therefore, the maximum effect of vaccinating older women will be seen only in those who were susceptible to infection (engaging actively with new sex partners) and had not been previously exposed to HPV. However, most of the women in the study who were or had been HPV-positive were positive to only one strain of the virus. This means that the quadrivalent HPV vaccine could still be beneficial in protecting older women against the HPV strains they had NOT been infected with.

Though these findings are encouraging, some scientists are not as optimistic that the Gardasil vaccine will be effective in the older female population. They claim the new study is simply too small and that the vaccine’s true efficacy in the study group won’t be seen for several more years; the study has only followed the women for about 2.2 years.

Even if longer-term and larger-scale studies confirm the efficacy of the vaccine for older women, the problem for many women who believe they could be at risk of HPV infection is that the vaccine is currently only approved for girls 9 to 24. This means that right now insurers will not cover vaccination for older women until the shots are proven effective and approved for the older population. The fact that the vaccine’s three shots cost about $375 (not counting fees the doctor may charge for the visits) means that though these study results are encouraging, few older women will pursue vaccination until insurance companies begin covering it for them.

Regardless of whether women at any age receive the Gardasil vaccine, all women should still receive routine Pap smears, which check for cancerous or precancerous changes in cervix cells. Pap smears are almost always covered by private insurance as part of a woman’s routine gynecological exams.

Alzheimer's affects 5 million Americans

The Blanchette Rockefeller Neurosciences Institute has partnered with Inverness Medical Innovations Inc of Waltham, Mass to speed development of the first commercial test to detect early-stage Alzheimer’s disease. The test could be available in 12 to 18 months, according to researchers, and would enable patients to try and slow the progression of the disease. Through regular testing, the test could be used to monitor the effectiveness of treatments, helping scientists to develop a medicine against the disease. Inverness Medical Innovations Inc will fund development of a home version of the test if the commercial version is successful. Today, early Alzheimer’s is often incorrectly diagnosed because tests are based on evaluations of the patient’s behavior, working to rule out other causes for symptoms of forgetfulness. Steps currently practiced to slow the disease’s progression include improving the patient’s diet, giving them more mental exercise, or entering them into a clinical study of an experimental drug. The only way to diagnose Alzheimer’s with certainty now is by looking for the disease’s signature pattern of brain damage during an autopsy after the patient dies. More than 5 million Americans have Alzheimer’s disease, and the number is increasing as the population ages.

How does the new test work? By detecting abnormal function of a protein shown to be involved in memory storage. A small skin sample is taken from the patient at a doctor’s office or testing center and shipped to the institute. Next, scientists grow the cells in a petri dish with a substance to stimulate the PKC enzyme. The enzyme combines with phosphorus in the skin cells. If there’s too much phosphorus in the combination, the patient has Alzheimer’s. The test has been tried on more than 300 patients in 15 hospitals. 42 of these patients were confirmed later by autopsy as having Alzheimer’s, and the test was 98% accurate on the autopsied patients. The test is not invasive, an improvement over other tests currently in development which necessitate painful removal of cerebrospinal fluid from the patient’s brain. The new test should also only cost a few hundred dollars, making it much  more affordable than expensive brain imaging, which searches for a pattern of plaque buildup in the brain indicating a predisposition toward Alzheimer’s.

The Blanchette Rockefeller Neurosciences Institute, founded by WV Senator Jay Rockefeller, is based at West Virginia University and is affiliated with Johns Hopkins University. The institute has also just received permission to begin its first small test in the US in Alzheimer’s patients for a treatment which uses a potent natural substance to activate the PKC enzyme in early stage patients.

This is the choice more and more small businesses are facing

According to a recent survey by the National Small Business Association, about 10% of small businesses are eliminating health insurance coverage over the next year. It’s either health insurance or jobs.

This isn’t the first decline in health insurance coverage over the past year. Only 38% of small businesses are providing health insurance coverage, down from 61% in 1993. About 19% of small businesses are planning on stopping coverage within the next 5 years.

Sheryl Weldon, owner of Texas-based Commerce Welding & Manufacturing Co. dropped coverage in December after seeing health insurance premiums for her employees increase by more than $600 a month in the last five years. Five years ago, Weldon was paying $200 per employee per month and this year premiums skyrocketed to more than $800. Premiums typically increase 8% to 16% a year for small businesses.

Kelly Reeves, president of KLR Communications, canceled health insurance for her three employees. Reeves said she had to choose between cancelling health insurance coverage and laying off an employee after losing a client that accounted for 50% of revenue.

Due to small businesses canceling health insurance coverage, more and more people are becoming uninsured. According to a report released by Families USA this year, approximately 86.7 million Americans were uninsured between 2007 and 2008. The report also found that nearly 75% of those uninsured were without health insurance for at least 6 months and almost two-thirds were uninsured for more than 9 months.

2009, a new President, and new health care buzz words are upon us. As one of the Principals of HealthPlanOne, Inc. (HPOne), we find ourselves in a perfect place to help so many people, and businesses nationally that have been subject to the wrong side of the bargaining table with insurance carriers.

Do you know how much your broker is earning in commissions on your benefits package? Is it worth the amount of work they do for you? Do they lower their fees/commissions when the amount of work they do diminishes, or do they continue to earn more and more as your premiums creep up?

These are all questions we have asked, and the answers have been disappointing lots of the time. Many brokers promise IT solutions, HR portals, and other services that you “pay for” and either never use, or they are never implemented. Does your broker then reduce fees? Probably not.

If you have not visited Health Plan One, you must. Whether searching for solutions to the part time staff you have, or to reduce dependent coverage, you owe it to yourself to check with us. All of the normal “blocking and tackling” of a benefits broker is the simple stuff, and we do that as well as anyone in the business. HPOne will do more work for you, for less commissions and will always keep its fees in line with your expectations. This is something ALL brokers neglect to bring to the table.

Please let me know if we can help in any way. As one of the fastest growing web brokers in the United States, and funded by 2 of the most well known venture capitalists in the world, we are here to help, when promises do not come true. We also have several former CEO’s on our board of directors that assist us when we must apply necessary leverage in the insurance marketplace.

Get what you pay for, choose HPOne.

-Chris Efthymiou

Small Group Business