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Thursday April 17th 2014



Americans Are In the Dark About ACA Deadlines

• Americans Are in the Dark About ACA Deadlines
• Enrollment Trends a Key Risk to Health Insurers
• Towers Watson Expands Exchange Solutions Segment
• HSA Asset Levels Are Growing
• Covered California Offers Quality Rating System
• Covered California Lands Federal Grant
• Prime and United Expand Hospital Agreements
• Vision Problems Lead Employees to Take Multiple Breaks
• Employees Are Confused about How the ACA Affects Vision Coverage
• LTC Price Index
• Long-Term Care Conference
• Whole & Term Life
• Universal Life
• Term Life
• ACA Education Tool
• Out-of-Pocket Calculator
• Wellness Tool


Americans Are in the Dark About ACA Deadlines

darkFifty-five percent of Americans don’t know the deadline to sign up for health insurance under the Affordable Care Act, according to a report. In fact, 24% said that the deadline had already passed on January 1, 2014, and 11% wrongly assume that they have until December 31, 2014 to sign up, a full nine months after the March 31, 2014 deadline.

More than three in five of Americans think the government will push the deadline back. While the Obama Administration has changed many of the other Affordable Care Act deadlines, Americans should not assume that the March 31st deadline will be moved, said insurance analyst Doug Whiteman.

Despite major efforts to inform young adults about the Affordable Care Act and the upcoming deadline to sign up for health insurance, 18- to 29-year olds are the most confused about the cutoff date and the most likely to think the government will push back the deadline. Whiteman said that it’s especially worrisome that young adults — who are the most likely to be uninsured — are the least informed about the deadline and the most likely to think it will be moved. Obamacare’s success hinges on young, healthy Americans signing up, so if they continue to procrastinate past the deadline, it could cause insurance premiums to increase.

Also, people who miss the March 31st deadline will have to wait until next year’s open enrollment period if they decide they want health insurance unless they experience a qualifying event in the interim, such as marriage , he said.

Thirty-six percent of Americans say their health care spending is higher than it was 12 months ago while only 7% say it is lower. Americans with annual household incomes of $30,000 to $49,999 are the most likely to know the correct Obamacare sign-up deadline. So far, about 80% of those who have signed up for coverage under the Affordable Care Act have received a subsidy from the federal government.

The survey also reveals that 33% of Americans are more negative about Obamacare than they were one year ago while only 12% are more positive. This is the largest spread since Bankrate started conducting these monthly surveys in August 2013. has a free calculator that helps consumers determine their eligibility and compare costs at

Enrollment Trends a Key Risk to Health Insurers

The difference between the age distribution assumptions made when insurers set premium rates on their exchange products and the actual age distribution will be a key determinant of the products’ financial results, according to Fitch. The more these pricing assumptions skew younger than actual experience, the greater the potential is for health insurers to experience adverse financial results from exchange-sourced business. It also increases the importance of risk sharing programs built into the ACA. This is especially true for insurers offering individual and small group products on state or Health and Human Services Department (HHS) managed health insurance exchanges.
According to HHS, as off Dec. 28, 2013, 24% of exchange enrollees were 18 to 34 years old. A Kaiser Foundation Family report estimates that number at 40%. Fitch says that healthy 18-34-year-olds who are eligible for exchange enrollment are more likely to delay their enrollment compared to older, less healthy people. The 2014 enrollment period remains open until March 31, 2014.
The HHS report indicates that eight times as many 18 to 34 year olds enrolled in an exchange-sponsored health insurance plan in December than in October and November. For more information, visit

Towers Watson Expands Exchange Solutions Segment

Towers Watson is uniting its health care exchange and administration resources. Towers Watson will combine the operations and associates of Extend Health, which it acquired in 2012; Liazon, which it acquired in late 2013; much of its North American Technology and Administration Solutions health care business, and other consultants dedicated to integrating health care exchanges into the existing Exchange Solutions segment. The result will be a much larger and broader business unit dedicated to helping employers deliver health care benefits to their employees and retirees through private exchanges and administration. For more information, visit

HSA Asset Levels Are Growing

HSA asset levels are growing, according to a study by the Employee Benefit Research Institute. In 2013, there was $23.8 billion in health savings accounts (HSAs) compared to $18 billion in 2012. The number of health reimbursement arrangements (HRAs) fell for the first time since 2005. In 2013, there were 4.7 million HRA accounts, down from 5.1 million in 2012. The number of people with HSAs increased from 6.6 million to 7.2 million. Assets in HRAs fell slightly at about $5.8 billion in 2013. Assets in HSAs increased from $11.3 billion to $16.6 billion from 2012 to 2013. Average account balances increased after leveling off. The combined average HRA and HSA account balance increased to $2,010 in 2013. It was $2,311 among HSA participants and $1,236 among HRA participants. People with an HRA or HSA for five years or more had $3,491 in their account. Those with an account for less than a year had less than $2,000 in their account.

Average rollover amounts decreased from $1,206 in 2012 to $1,165 in 2013. Total assets being rolled over also decreased: $9.2 billion was rolled over in 2013, down from $9.8 billion in 2012. The percentage of people without a rollover who had an account for more than a year was 10% in 2013. For more information, visit


Covered California Offers Plan Quality Ratings

California consumers can now get performance ratings on the vast majority of health insurance plans offered through Covered California. The state health insurance exchange recently added a quality rating system to its website to help consumers chose plans. The ratings are based on reported experiences of members.

The quality-rating system gives an easy-to-understand rating of one to four stars. The system is in place well ahead of the 2016 federal mandate and will be improved over the next two years as the exchange gets more comprehensive performance ratings for plans. “Covered California is now among the first exchanges in the nation to offer its consumers a quality rating system. Many states, along with the federal exchange, are awaiting federal guidelines for establishing a rating system, but Covered California wanted to give existing scoring information beginning in 2014,” said Covered California executive director Peter V. Lee. For more information, visit

Covered California Lands Federal Grant

After a successful launch that enrolled nearly a half-million Californians in health insurance plans, Covered California received additional federal funding. The $155 million grant will allow Covered California to expand marketing and outreach activities, especially aimed at young adults and uninsured Hispanics. The grant will also be used to bolster the small-group employer market; build more robust data analysis; support health plan renewal; hire and train staff in enrollment assistance, communications and consumer protection areas; and augment existing enrollment system technology to improve the consumer experience and to keep up with emerging state and federal requirements. Covered California’s previous federal grants total about $910 million for planning and development of the exchange. The new funding, called a “supplemental grant,” will go toward sustaining and extending these programs. For more information, visit

Prime and United Expanded Hospital Agreements

Prime Healthcare has expanded its contractual agreements with United Healthcare, which now includes 14 Prime Healthcare hospitals in its coverage. United Healthcare members will be able to get care at in-network benefit levels from Alvarado Hospital Medical Center in San Diego, Centinela Hospital Medical Center in Inglewood, Chino Valley Medical Center in Chino, Desert Valley Hospital in Victorville, Encino Hospital Medical Center in Encino, Garden Grove Medical Center in Garden Grove, Huntington Beach Hospital in Huntington Beach, La Palma Intercommunity Hospital in La Palma, Montclair Hospital Medical Center in Montclair, Paradise Valley Hospital in National City, San Dimas Community Hospital in San Dimas, Shasta Regional Medical Center in Redding, Sherman Oaks Hospital in Sherman Oaks and West Anaheim Medical Center in Anaheim. This agreement gives United Healthcare’s insured commercial and Medicare members access to all of Prime Healthcare’s 14 California hospitals. Previously, only Alvarado Hospital Medical Center, Garden Grove Hospital Medical Center, and San Dimas Community Hospital had contracts with United Healthcare.


Vision Problems Lead Employees to Take Multiple Breaks

Many employees regularly face at least one visual disturbance that could diminish their work performance, with most taking multiple breaks to rest their eyes, according to new research sponsored by Transitions Optical. The company’s annual survey reveals that 79% of employees encounter at least one visual disturbance, and 53% take at least one break daily to rest their eyes because they hurt or feel uncomfortable. The top visual complaint is tired eyes, with 47% of employees reporting this. About a third of employees are bothered by other problems, including light reflecting off of their computer screen, bright, glaring light, dry eyes, and blurry vision. Another 18% say their eyes tear while 16% have trouble with light reflected off of personal devices; and another 16% are bothered by reflections off of outdoor surfaces.

Twenty-nine percent of workers say that visual disturbances give them headaches. According to the National Headache Foundation, headaches cost the nation $17 billion dollars in absenteeism, lost productivity, and medical expenses. While 90% of employees say headaches affect their work performance, only 33% tell their employers, indicating that this may be a bigger issue than employers realize. Thirty-two percent of employees say their eyes bother them most in the afternoon, followed by 24% in the evening, and 8% in the morning. An additional 17% say their eyes  bother them throughout the day.

With so many workers reporting visual disturbances, it’s not surprising that 53% take breaks during the workday to rest their eyes. In 2011, only 29% were reporting breaks. Smith Wyckoff of Transitions Optical said, “That means there has been a 45% increase in people taking breaks from their workday to rest their eyes in the past two years, potentially a result of employees working longer hours and being exposed to more electronic devices.”

Further demonstrating the negative affect on productivity, most employees are taking multiple breaks throughout the day on account of vision problems. The average employee takes two breaks per day, but 32% are taking three or more breaks, and 13% are taking more than five. While women are more likely to say they suffer from visual disturbances at work, men are more likely to say they take breaks because of them.

One study shows that eye-focusing problems, which can occur with eyestrain and fatigue, may cause employees to lose up to 15 minutes of working time a day. This translates into employers losing more than $2,000 per year per employee who suffers from this issue. Many visual disturbances can be alleviated with wearing the right eyewear with anti-reflective coatings and lenses to reduce glare. For more information, visit

Employees Are Confused about How the ACA Affects Vision Coverage

There is confusion and concern among the majority of Americans when it comes to how health care reform will affect vision benefits, according to a recent survey supported by Transitions Optical. According to the survey, conducted in November 2013, nearly six out of 10 employees don’t understand how health care reform will affect their vision insurance coverage; and more than half are worried about changes to vision coverage due to the Affordable Care Act.

Smith Wyckoff of Transitions Optical said, “The fact that this lack of knowledge is translating into concern is something worth addressing, as vision plans and employers have the opportunity to enhance their relationships with employees by keeping them informed and alleviating their fears.” Employee are  concerned about experiencing cost increases, having different vision coverage than their children, and not understanding how to get covered or reimbursed.

Four out of 10 employees expect their human resources representative to be knowledgeable on this topic while nearly half expect their vision insurance carrier to be knowledgeable. The source most employees (59%) expect to be knowledgeable is their eye care professional. Fewer (30%) expect their primary care physician to be informed.

Despite employee confusion about health care reform, interest in vision benefits is higher than ever, according to the survey, with 83% of employees choosing to enroll – a significant increase over previous years (78% in 2012 and 76% in 2011). Use of the plans for an eye exam is also significantly higher than in previous years — 79% in 2013 versus 64% in 2012. This suggests that education on the importance of preventive eye care may be having a positive effect. But, there is still room for improvement since more than one in five still are not using their benefits for a comprehensive eye exam for themselves or their children. This is a bit surprising, according to Wyckoff, since 92% of employees agree that having vision insurance would make them more likely to take their child for an eye exam. For more information, visit


LTC Price Index

Costs for long-term care insurance have risen slightly for couples, and increased more significantly for single women, but have actually decreased for men according to a 2014 report by the American Association for Long-Term Care Insurance (AALTCI). A 55-year-old single man can expect to pay $925-per-year for $164,000 of long-term care insurance benefits according to the AALTCI report. He’ll pay $1,765 for coverage that increases the benefit pool to $365,000 at age 85, a 14.5% decline from last year’s average.

Jesse Slome, director of the national trade group said, “We advocate a good, better, best approach to long-term care planning for those in their 50s and 60s. Good coverage provides $164,000 of available benefits for each spouse. Better coverage includes an option to add future coverage. The Best option, also the most costly, includes an automatic inflation growth feature.” Today’s average cost is $3,840-per-year for best coverage for a 60-year-old couple each purchasing $164,000 of immediate coverage, growing to a combined benefit pool of $730,000 ($365,000 each) at age 85. “That’s a three percent increase from the 2012 average ($3,725) and 4.8% higher than 2012 ($3,663),” Slome said.

Single women face the greatest cost increase compared to last year. Slome explains, “Last year, leading insurers began charging women higher premiums. Women accounted for two-thirds of the $6.6 billion in long-term care insurance claim benefits paid out.” A 55-year-old single woman would pay an average of $1,225-per-year for the same level of benefits available to a single man for $925 according to AALTCI. The typical single woman will pay an average of 12% more than in 2013. The Association study continues to reveal a significant spread between rates charged by insurers. “No one insurance company is always the least or the most expensive. One insurer will literally charge more than double for virtually the same level of benefits,” Slome notes. The AALTCI study reported differences that ranged from 31% to as much as 114%. For more information, visit

Long-Term Care Conference

The Intercompany Long-term care Insurance Conference Assn. (ILTCI) is holding its 14th annual conference March 16 to 19 at the Rosen Centre in Orlando. For more information, visit


Whole & Term Life

Aflac is offering two newly enhanced insurance plans: Aflac whole life and Aflac term life. Plan highlights include face amounts up to $500,000 and a guaranteed-issue option. The whole life insurance plan provides coverage and builds cash value for the life of the policy. The term life insurance plan offers coverage at a fixed rate for a length of time of the policy, typically for a 10, 20, or 30-year plan. Aflac’s whole life and term life insurance face amount options are offered for up to $500,000 for people under age 50 and up to $200,000 for people from 51-70 or 51-68 years of age for the whole and term plans, respectively. Guaranteed-issue is also available for the primary insured for a $20,000 or $25,000 of term life coverage. For more information, visit

Universal Life

AXA has launched BrightLife Protect, a cost-effective universal life insurance policy designed to meet the protection needs of people, families and businesses. Premiums can be allocated to a fixed account (guaranteed interest account) that offers a guaranteed rate of return and/or to a select account that offers upside cash value accumulation potential and a guaranteed 0% floor, which protects from losses due to market performance. There is also a long-term care service rider. For more information visit

Term Life

Securian’s Minnesota Life has introduced a term life insurance product with simplified application and underwriting and customer-friendly digital enrollment. MyLife Select term life insurance offers up to $250,000 of coverage and a level premium for policy terms of up to 20 years. An accelerated death benefit rider, included at no extra cost, provides early payment to insureds who have been diagnosed with terminal illness. After the coverage has been in force one year, insureds have five years (until age 65) to convert the policy to whole life. Insureds also have the opportunity to renew the policy annually after the original term expires without additional underwriting until age 85 (premiums will rise annually). For more information, contact Ryan Frantzen, national sales director, Securian Financial Institution Group, at or 651-665-1497.

ACA Education Tool

NavGate Technologies introduced is CareOptions Family Healthcare Advisory Program. It offers employees and their family members up-to-date, ACA information and estimates their potential federal subsidy with CareOptions. Employees and their families can research the quality and cost of many healthcare providers and facilities. They can also get early detection and care needs assessments; create a healthcare advance directive and power of attorney for healthcare; develop a care plan; and learn about medical conditions. CareOptions also allows employers or the worksite benefit provider to communicate benefit offerings and information directly to each employee, keeping them engaged and informed. For more information, visit

Out-of-pocket Calculator

National Health Council introduced an out-of-pocket cost calculator at Patients can estimate their costs based on their expected health care needs, including prescription medications, and choose from six patient scenarios to see how changes in health needs affect the selection of insurance plans.

Wellness Tool

The Abacus Group and Health Options Worldwide are offering a wellness engagement tool, myHINT, to agents who work with Abacus. Through their virtual health coaches, employees get monthly reminders about the risks to their health, and the recommendations that can mitigate those risks. For more information, visit