It appears that the plan finder tool at http://www.medicare.gov is being worked on and updated. We are seeing fewer errors on the tool today versus yesterday. Good sign that somebody at CMS is working on this in spite of the shutdown.
The government shutdown has resulted in a delay in CMS publishing the 2014 Star Rating Data. There is no indication as to when this information will be available. When it is published by CMS, we will include the 2014 ratings in http://www.medicarequoteengine.com for agents use.
Although I typically blog on Medicare matters for agents, I wanted to weigh in on week one of the Affordable Care Act’s first ever Open Enrollment. The Open Enrollment will last for 6 months from October 1st, 2013 through June 30th, 2014, although those looking for coverage effective 1/1/2014 will need to apply by 12/15/13. There were a couple main tenants of the ACA which stuck out in my mind:
- Shopping for Health Insurance will be as easy as comparing airline prices on Kayak. Not so much. I think this generalization was always a bit of a stretch, however, the current “glitches” in the healthcare.gov website look problematic. Will they be resolved? Eventually, but it’s hard to say if this will occur in days, weeks or months.
- If you like your Insurance, you can keep it. Maybe. However, many individual policies are being terminated and many employers are eliminating coverage for part time employees or employee spouses and driving them to the exchanges. We may see the same impacts on the small group market over time, as well.
- You can keep your doctor. Possibly. Most plans are keeping their costs low by using “narrow networks”. The lower than expected premiums on the exchanges are likely a result of these narrow network plans. As a result, access to care or keeping your doctor may not be an option if you opt for one of these plans. For example, in Washington state, Seattle Children’s Hospital is suing the DOI for approving plans that exclude them from the network. Five of the seven plans in Washington state do not include SCH and SCH is the only local hospital that performs many complex surgeries for children. In Dallas, only one of three plans include Baylor Hospital. Expect these narrow networks to become a bigger story as the ACA rolls on. Look forward to more lawsuits as hopitals find themselves locked out of certain markets.
- The ACA will bend the cost curve. Almost a definite no, in current form. The ACA was constructed with an 80% mandatory minimum loss ratio and many of the low income shoppers are price insensitive (meaning, their premium, regardless of what the insurance company charges, is capped by their income). Therefore, a plan with a higher premium and broad network (although perhaps not appealing to a non-subsidized shopper), could look quite good to a shopper who’s premium is capped based on income. This provides an incentive for the insurance company to charge higher premiums, pay out strong reimbursements to providers to ensure broad participation, to maximize the premium per enrollee and therefore maximize the 20% that they are allowed to keep. The additional premium is invisible to the shopper with a cap on premium and therefore simply gets passed onto the taxpayers. Frankly, I’m a little surprised there aren’t more high premium, broad network plans to attract the price insensitive shopper, but maybe I’m missing something here??
All in all, it will be interesting to see what the coming weeks unfold. There are certainly benefits to the ACA for many Americans, but there are also issues in the law that will cause “unintended consequences”. Unfortunately, while it would be preferable to see some of these provisions improved, it seems that there is little appetite to improve the law and the options are to keep it as is or to repeal it.
Now, back to Medicare!
Although it appears that you can view 2014 plan data on the Medicare.gov website via plan finder, it appears that the data was partially loaded and stopped due to the Government shutdown. You will see this disclaimer on the top of Medicare.gov:
At first, we thought this was just a “warning” and that the data might be OK for 2014 (since it appears to be displaying), however, as we looked closer at the data to validate some plan information, we’re finding a good bit of the data is incorrect or not available. For example, when we look for plan details, we get this error message:
It’s possible that some of the 2013 data is mixing with 2014, we’re not exactly sure, but this is going to delay our ability to publish accurate data on 2014 plans on http://www.medicarequoteengine.com. We’re still working on this!
Here is a link to the Benefit Adviser TV Episode which covered the Ritter Medicare Summit in Atlanta. The Summit was sponsored by Aetna Medicare, Coventry, Humana and Piedmont Wellstar Health Plans. We were pleased to have the top marketing professionals from each of our sponsors attend to present their product offerings for 2014. Additionally, we provided some video marketing ideas from Bart Camarata and a motivational talk from Nelson Griswold. I also presented a 20 minute talk on how the ACA was impacting the Medicare advantage market in 2014 and how brokers needed to position their businesses to thrive over the next 5 years.
As a part of the Summit, we were able to provide some of the attendees with videos they could use in the Video marketing. For example, here is a short spot from Dallas Strickland.
A special thanks to the 100 or so Atlanta brokers who attended the meeting! We got great feedback on the meeting and I hope everyone was able to take away important business ideas and product knowledge to assist their clientele.
CMS issued a press release late last week, you can read the Press Release here. Medicare Advantage premiums for 2014 are expected to increase by $1.64 to $32.60/month. Medicare Part D premiums for 2014 are expected to hold steady for the fourth year in a row at around $31/month.
The number of 4 star plans is expected to increase from 28% to about 1/3 of all plans. This could be a result of either more four star plans or 3.5 and lower star plans exiting the market. Further, about 50% of Medicare beneficiaries are expected to be in 4 star plans, up significantly from 37% last year.
Here is the story from Philly.com (Philadelphia Inquirer). The story notes that the repayment will be $225,000 which is a fantastic result for Cigna, given the implications of larger overpayments. Bravo was acquired by HealthSpring and then HealthSpring was acquired by Cigna. The audit only looked at 2007 when Bravo only had 13,755 members. Subsequently, the plan has grown to approximately 75,000 members in PA (a 450% increase) with most residing in the Philadelphia five county area.