Telemedicine, A Winner in Reduced Claims!

     Mercer’s National survey of Employer-sponsored Health plans noted a significant savings when members have telephone visit access to physicians.

     According to the Mercer survey, Telemedicine offerings by large employers surged to 59% this year as compared to the 30% in 2015. Telemedicine plans are also becoming very popular with small to medium size businesses.

     The key to the success of the program is utilization of the benefit. From our experience, if the benefit requires a co-pay for the consultation, the utilization will be very low, and the employees will not take advantage of the tremendous benefits of this program. That is the reason our plan requires NO CO-PAY and covers the entire family.

     In our agency, we have a group that has a savings YTD of over $200,000 in reduction of medical visits at doctor offices and the ER. It is a proven fact that a viable Telemedicine program can reduce medical claim utilization by as much as 70% if the employee has a direct 800 number to talk to the doctor.

The Wall Street Journal (2/22, Tergesen, Subscription Publication) reports that beginning in 2019, Medicare beneficiaries with high incomes must pay a larger share of their medical costs. This article says this is another attempt to transfer more Medicare costs to the wealthiest seniors. The piece adds that as of next year, beneficiaries who have incomes of $500,000 or more and couples with the income of &750,000 or more will be placed into a new category and asked to pay 85% of what their parts B and D benefits cost. At present, they are paying 80% of those costs.

PACE Act Signed

ACA Small Group Market Rule Repealed

On Oct. 7, 2015, President Obama signed the Protecting Affordable Coverage for Employees (PACE) Act into law. The PACE Act repeals the Affordable Care Act (ACA) requirement that the small group market in every state be expanded to include businesses with 51-100 employees.

Although some sources questioned whether he might veto the law, the President signed the PACE Act into law in light of its bipartisan support in Congress.

To read this entire Health Care Reform Bulletin click here.

2nd Quarter 2015 Benefits Bulletin

IN THIS ISSUE

• IRS Invites Comments on Cadillac Tax Implementation

• DOL Issues Final Rule to Expand FMLA Protections for Same-sex Spouses

• DOJ to Allow Claims Based on Gender Identity Discrimination

• New Guidance and Relief for Employer Payment of Individual Premiums

To read these articles and to see the entire Bulletin click here.