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The Holidays Brings More LTCi Inquiries from family members

Insurance Offered to Fewer Workers in Small Firms As Compared To Larger



Businesses with fewer than 50 employees



Businesses with 100 or more employees




Only 49 percent of workers in businesses with fewer than 50 employees were offered and eligible for health insurance through their employer in 2010, down from 58 percent in 2003, according to a recent Commonwealth Fund report. In comparison, 90 percent of workers in businesses with 100 or more employees were offered and eligible for health insurance in 2010 and 2003. These results show that as health insurance coverage eroded in the years before the passage of health reform, workers in small firms struggled with the cost of health care. In fact, 45 percent of small-business employees reported difficulty with medical bills in 2010, and 46 percent reported that going without needed care because of cost. Thirty-three percent of employees in firms with 50 or more employees reported problems meeting medical bills, and 35 percent did not get recommended medical care due to cost factors. Just one-third of workers making less than $15 an hour in small firms were both offered and eligible for their employer’s health plan, while 70 percent of those making over $15 an hour in a small firm were offered health benefits. The Commonwealth Fund’s report, Jobs Without Benefits: The Health Insurance Crisis Faced by Small Businesses and Their Workers, by senior research associate Ruth Robertson and colleagues, is based on findings from The Commonwealth Fund’s 2010 Biennial Health Insurance Survey and analyzes the health insurance and health care experiences of workers according to workplace size and income.


In the same way that many employers have shifted employees’ retirement packages from defined benefit plans to defined contribution options, some will be to applying that approach to health care benefits in 2013. According to benefits consultant Aon Hewitt, a recent survey of 113 Ohio-based companies found that employers will deduct an average of $2,000 from their workers’ paychecks next year to help pay health care premiums. Many will start penalizing workers who do not participate in wellness activities by charging premiums 10 to 15 percent higher In addition, the survey found that 15 percent of employers are likely to allot their DID YOU



employees a set amount of money to buy health insurance from a private-sector health exchange. Other local employers reported seeing benefits from incentives, such as a cash award program for physically active employees, each of whom can earn up to $500 in a calendar year. Sixty-two percent of participants in a biometric program lowered their blood pressure, while 24 percent improved their body-mass index scores.

CHRISTIANS-ONLY INSURANCE MEMBERS GET REPRIEVE A Kentucky circuit judge will allow the Christians-only health insurance plan, Medi-Share, to

DEC. 15 IS THE NEW DEADLINE FOR STATES that want to run their own exchanges to make that intention known. States that don’t go that route will have until Feb. 15 to decide whether to work in partnership with the federal government or cede their exchange entirely to Washington. Source: Dept. of Health and Human Services news release

42 InsuranceNewsNet Magazine » December 2012

QUOTABLE States have and will continue to be partners in implementing the health care law and we are committed to providing states with the flexibility, resources and time they need to deliver the benefits of the health care law to the American people. — Kathleen Sebelius, Dept. of Health and Human Services, in a letter to Republican governors, 11/9/12

be allowed to continue coverage for its 800 Kentucky members until January 1. The judge ordered the organization disbanded because it doesn’t comply with state insurance regulations. The Florida-based Medi-Share is similar to secular insurance, but restricts participation to churchgoers who sign a pledge to abstain from alcohol, tobacco, drugs and sex outside of marriage. The organizers of Medi-Share claim that its members are aware that the program does not take the place of traditional insurance but is rather a charitable endeavor to help cover medical bills of fellow Christians with the potential of members having their own expenses covered should the need arise. The Medi-Share website outlines the treatments, medical conditions, procedures, and services that are ineligible for sharing, which are classified as expenses related to non-biblical lifestyles and choices.


The Department of Health and Human Services (HHS) has given states more time to finish their health insurance exchange planning, extending a deadline that expired on November 16, 2012. Under the health reform law, states are required to determine whether they will establish a state-based health exchange, or have the federal government operate in the state. The Administration announced an extension for the Exchange Blueprint, but allowed the November 16 deadline for the Declaration Letter to stay in place. States have until December to submit their health exchange blueprint to HHS.

December 2012  

2013 Outlook

December 2012  

2013 Outlook