DOL proposes changes to Form 5500

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The U.S. Department of Labor plans to revise Form 5500 to require insurers and health plans to report more information. The proposed changes focus on five broad goals: modernizing financial reporting, providing greater information regarding group health plans, enhancing data mineability, improving service provider fee information, and enhancing compliance with ERISA and the tax code. One element that is sure to attract the attention of smaller employers is a proposal to eliminate the exemption ...

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Study finds Wisconsin has high healthcare prices

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A study released this month by the nonprofit Health Care Cost Institute found that Wisconsin has the second highest healthcare prices among the 41 states it surveyed. The study was based on claims data from UnitedHealthcare, Aetna, and Humana, which the Institute said represents 34% of total commercial claims in Wisconsin. The study found that prices in Wisconsin for over 200 common medical services were on average 81% higher than the national average, and that the ...

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Is Retail Medicine Really a Smart Choice?

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Smart Choice MRI and ThedaCare announced this month that the Appleton-based health system is investing $3 million in the Mequon-based stand-alone MRI provider. In the announcement, ThedaCare’s senior vice president of Systems of Care Support, Keith Livingston, described the partnership as a collaboration with a competitor that is “consistent with our need to learn how to better meet consumers’ needs in the evolving retail health marketplace.” Livingston also told the Milwaukee Journal Sentinel that “[h]ealth care ...

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Drug Costs Continue To Rise

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Although the rate at which overall health costs are rising is historically low, employers, experts, and politicians are expressing alarm at the rising cost of prescription drugs. According to a recent Aon analysis, the average health care rate increase for mid-size and large companies in 2015 was 3.2%. Prescription drug costs, however, jumped by 10% last year according to a report by Truveris that was publicized by the Business Health Care Group.

In general, hospital expenses account ...

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Aetna-Humana merger drives fee-based model

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With Aetna poised to acquire Humana in 2016, industry observers have noted how industry consolidation generally and Aetna’s growing market share in particular will lead more intermediaries to adopt a fee-based compensation model. Although fee-based compensation for intermediaries is not a new concept, it is far less common than traditional commission based compensation. However, it appears increasingly likely that fee-based compensation will become much more widespread in the coming years.

Traditionally, insurance agents and brokers have been paid for ...

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Many reasons for Milwaukee area’s high health costs

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An article by Guy Boulton in Friday’s edition of the Milwaukee Journal Sentinel looked at four studies on health costs and concluded that the Milwaukee area has some of the highest health care costs in the nation. The studies were conducted by the Government Accountability Office, BSG Analytics, Milliman Inc. and the Institute of Medicine over different periods of time with different methodologies.

Despite these differences, the article is correct that Southeastern Wisconsin health care costs are not competitive when ...

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Survey Shows Strong Employer Interest in Health Benefits, Private Exchanges, and Independence

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Independence

A recent survey of over 400 employers reveals that employers are committed to offering health benefits to active employees, and that interest in private exchanges remains strong. In addition, the vast majority of employers surveyed reported that it is very important for their advisors to be independent of any exchange solution they ...

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Employers taking steps to drive health plan value

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Employers are continuing to take steps to get the most value out of their employee health plans. Responses from the 2014 Towers Watson/NBGH Employer Survey on Purchasing Value in Health Care show that the best-performing employers are acting aggressively to improve their health plan cost trend and also help employees manage their well-being. Steps taken by employers include establishing coverage tiers based on the number of covered dependents, modifying health ...

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Consumer-driven health plans offer opportunities for employers, employees

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Consumer-driven health plans (CDHPs) continue to grow in popularity due to the opportunities they offer both employers and employees. According to America’s Health Insurance Plans (AHIP), CDHP enrollment rose to 17.4 million in 2014, an increase of 6 million since 2011.

Consumer-driven health plans can be distinguished from traditional health plans by their higher annual deductibles and the opportunity to invest in a Health Savings Account (HSA). Higher deductibles make members more mindful of the cost of their care, which promotes ...

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Insurers Team Up to Release Some Provider Data

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On the heals of Medicare’s recent release of payments made to physicians and hospitals , UnitedHealth Group, Aetna Inc., and Humana have teamed up to provide some price transparency for consumers.  The insurers have aggregated their data to provide a reference price for health care services in their community.  Customers of those insurers will receive more detailed information.  There will be limits on the information, as it is proprietary for the insurers.  The amount paid to specific doctors and hospitals will not ...

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