price drop anticipated on some popular brand name prescriptions
One of the most expensive aspects of many people’s healthcare is their prescription costs. As copays have climbed in recent years, individuals with high prescription usage have felt more of the burden of high costs for brand name medications.
Just like other products, new medications are produced under patent when they are first introduced. That means that it is illegal for another pharmaceutical company to reproduce the medication in a chemically identical form. If that particular prescription is what works for a patient, they are often stuck with paying a higher cost-share in order to get the brand name.
Over the course of the next 14 months, however, the patents on a large number of brand name drugs are expiring, which typically results in immediate generic equivalents on the market. With copays for generic medications the most affordable, the increased competition will most likely result in some outstanding cost-savings for consumers. The two top-selling drugs in the world today, Lipitor and Plavix, will both have expired patents soon, according to the Associated Press.
Generic equivalent meds work just as well as the brand names for most patients, and some insurers will require that a generic is administered when it’s available. Because this is constantly changing, be sure to communicate with both your pharmacist and your physician on the right medication for your situation.
Insurance agents and brokers can also help you to research your medications to see how they fall within your plan. Although generics are almost universally covered by plans that carry prescription coverage, different carriers do sometimes classify brand name medications at different levels – what is paid for in full after a $25 copay on one plan might be only covered at 50% on another. Call us today to ensure that you’re on the best plan for your individual or business needs.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
overweight people don’t think they’re overweight, study shows
Not only is the obesity epidemic effecting physical aspects of our health, it is impacting our mental perceptions of health as well. With nearly two-thirds of the adult population considered overweight or obese and one-third of children, it is no surprise that the United States is seeing an increase in diabetes and other chronic weight related illnesses.
What may come as a surprise, however, is the idea that Americans have lost our perception of what is considered heavy. As the numbers of overweight people have increased, many are starting to consider these extra pounds normal and are not feeling the need to put in the effort to lose the weight.
According to CNN, a study done by Columbia University surveyed overweight moms and children and had some unfortunate results: 82% of the overweight women and 86% of overweight kids underestimated their own weight, compared to the 13% and 15% respectively who were of a normal weight. Additionally, nearly half the mothers who had an overweight child thought their child was a normal weight. The children were given cards with many different body shapes on them and when asked to pick a healthy shape for their mothers, they usually picked a shape that was not in a healthy range.
Although this study was too small to represent the whole United States, it did provide evidence that perceptions of a healthy weight have been skewed. With this problem on the rise, healthcare professionals are seeking ways to help people help themselves and reduce this epidemic through outlets like exercise, diet and preventative care.
As part of the new Healthcare Reform laws, preventive care is now covered in full as plans renew throughout the year. Part of preventive care is obesity screenings and advisement for both children and adults. Insurance agents can review your plan options and determine how such screenings will be covered on your current policy or perhaps recommend alternatives. Things are constantly changing in this market, so it’s always a good time to evaluate.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
rate increase delays in California
California based insurer Blue Shield announced recently that it would delay their rate hike scheduled for March 1, 2011 for an additional 60 days. This announcement marked Blue Shield joining a few other insurers in delaying their rate hikes at the request of the insurance commissioner, according to the Huffington Post. If Blue Shield’s increase had been put in motion, this would have marked their third increase since October 1, 2010. These three increases would have boosted the customer premiums at an average of about 30%, with some having the potential to see a 59% increase if all three hikes had been put in place.
Premium increases cannot be fully rejected, but the Insurance Commissioner can request a delay in order to analyze these increases to be sure they fall within federal and state laws. Blue Shield chairman and CEO Bruce Bodaken stated that the rate increase was necessary to help meet the new medical loss ratio standard, which is the proportion of policy premiums to be spent on medical care versus administrative costs.
We had a similar situation here in Washington just this past month. Regence Blue Shield had their annual rerate on October 1, 2010, and was denied the additional rerate request to take place January 1, 2011 by the Washington State Insurance Commissioner. Curious about what your future with these premium increases may hold? Health insurance agents are always here to help determine how these changes may affect you, your premiums, and your family’s coverage levels.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
Wallace Rice Benefits, LLC achieves A+ rating with Better Business Bureau Accreditation
Today, Wallace Rice Benefits, LLC announces its commitment to marketplace ethics by earning a/an A+ rating with Better Business Bureau. As a BBB Accredited Business, Wallace Rice Benefits LLC has met BBB's Code of Business Practices and has agreed to maintain honest and reliable business practices.
"Better Business Bureau sets and upholds the highest standards of ethics in business," said Robert W.G. Andrew, CEO of BBB serving Alaska, Oregon, and Western Washington. "BBB rates both BBB Accredited and non accredited businesses on a letter grade rating scale of "A - F" to help consumers make educated decisions before they do business."
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
AWB announces rate decreases for small groups
In this tumultuous time of healthcare reform and some substantial rate increases, it’s easy to feel overwhelmed. A recent announcement, though, should brighten the spirits of small business owners looking to insure their employees. Not only do many small businesses qualify for the new tax credit, but the Association of Washington Business (AWB) has announced that their rates for December 1 are 4% lower than those released for November 1, 2010.
Rate decreases in this marketplace are unusual, but AWB has managed over the years to moderate their rate changes. As an association plan, they determine a small group’s rates not just by age and location, but also by gender and health history. Groups of 2-14 enrollees are considered age-rated groups, and they are the ones seeing the most cost-savings.
Group coverage is a tricky thing, designed to offer substantial benefits to employees but often costing the employer more than they’d anticipated. Agents are available to help employers muddle through the plan options, including considering association plan options like the AWB.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
small business tax credit for health insurance premiums
Beginning with the 2010 tax year, small businesses may be able to receive a tax credit if they offer group health insurance coverage to their employees. In order to be a qualified employer, the group must meet certain criteria:
- The employer must have fewer than the equivalent of 25 fulltime employees
- The average annual wages of the employees must be less than $50,000 per fulltime employee
- The employer must pay the premiums under a "qualifying arrangement"
If all of the qualifications are met, an employer group could receive a tax credit of up to 35% of the paid premiums when filing their annual taxes for 2010. Similar credits are also available for tax-exempt organizations.
Although we encourge small business owners and administrators to contact their tax professional to see how these changes might effect them, additional information is also available on the IRS website. And never hesitate to call your agent with questions or concerns, or to see if a group plan might be a good fit for your small business.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
healthcare reform – september 2010 changes
On September 23, 2010, the six-month anniversary of President Obama signing the Healthcare Reform Bill into law, some major changes are starting to be felt by consumers. Although most aspects of the bill won't be in effect until 2014, this is the first palpable step for many insureds across the country.
- As of 9/23, as plans renew, children under 19 can no longer be denied coverage based on a pre-existing conditions.
- As of 9/23, as plans renew, plans may no longer have a lifetime benefit limit in place.
- As of 9/23, as plans renew, policies must cover preventive care at 100%. No deductible, copay, or coinsurance amount may be collected from the patient.
- As of 9/23, as plans renew, policies must allow parents to cover dependents on their policy until their 26th birthday
Please note, though, that these regulations go into effect as a plan renews each year. Say, for example, an insured is on a plan through an employer. If that employer's annual renewal isn't until March of next year, these changes may not go into effect until March. And, if a plan is grandfathered with little or no change in benefit or rates, there is the possibility that the plan may not be forced to adopt these changes.
It's a tangled web of information, with the Healthcare Reform Bill being an over 2000-page document that even insurers are having difficulty diciphering. News providers like USA Today are providing some of the information, but there is still a lot to learn. Insurance agents are here to help determine how the constant changes affect you.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
small business + healthcare reform
Small businesses are one of the entities likely to feel a significant impact with healthcare reform. Some of the major changes are already taking effect, though the most substantial changes won't happen until 2014. One thing that has been neglected in many of the news briefs about reform, however, is the utilization of agents.
Health insurance agents, brokers, and producers are still going to be available to be your first point of contact in muddling through the reform bill and how it will effect your business. Even when the Health Insurance Exchanges are up and running, nothing in the bill prevents businesses (and individuals, for that matter) from continuing to use their agent.
There are no additional costs involved in using an agent for a group of less than 50 employees, nor for individuals and families.
For more information on healthcare reform and how it will effect you and your business, see http://www.healthcare.gov/foryou/small/index.html
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
preventive care – new coverages
Preventive services are covered on most health insurance plans in Washington State. And what qualifies as preventive tends to be fairly simple... If there isn't a complaint or a diagnosis attached to the claim, the doctor will bill it as a preventive service because the purpose of the visit was to prevent illness.
Healthcare reform is bringing lots of changes to our business, and coverage for preventive care is no exception. In addition to abolishing costshares for patients on preventive services, there are also going to be some new benefits available on plans beginning or renewing after September 23, 2010.
In an effort to curb some of the more troubling and preventable afflictions that affect Americans, preventive care will start to include counseling for tobacco cessation, obesity screening and counseling, alcohol abuse screening and counseling, and HIV testing for high-risk individuals.
With additional services, however, often comes additional costs. The Obama administration estimates that the more comprehensive preventive benefit will result in an average 1.5% rate increase on medical plans.
You can view a side-by-side comparison of the preventive benefits on individual plans at: http://www.wallacericebenefits.com/content/quotes/health_insuranc.asp
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173
preventive care
Coverage for preventive services is one of the MANY things that will be changing with healthcare reform. What, however, qualifies as preventive?
In Washington state, we've been lucky enough to already have a fairly progressive healthcare system, in which preventive services are already a staple of almost all plans. One change we will see is that plans renewing or starting after September 23, 2010 will not be allowed to charge a copay, coinsurance, or deductible to the patient for preventive services. As with anything in the world of health insurance, there are exceptions, like if the patient chooses to see an out-of-network provider for the services then there may be a cost-share.
The bigger question is: what services are considered preventive? This is a tricky one, always has been. If a patient goes in to the physician's office for a regular check up with no complaints, then that service would be preventive. Services like cancer screenings, immunizations, pap smears and cholesterol checks are generally considered preventive as well.
This is where is gets confusing, though, and we've unfortunately seen this issue arise a number of times. Say a well person goes to have a colonoscopy, for example, as a preventive measure, and while the procedure is being performed the physician finds a polyp that needs removal. The doctor performs the polyp removal while the patient is under anesthesia. Suddenly, there is a diagnosis attached to the services, and the doctor must bill for that polyp diagnosis. That preventive colonoscopy is no longer going to be considered preventive by the insurance carrier.
Will the changes effect us in Washington state? Maybe... There are some added benefits in the government's bill that haven't traditionally been included in preventive care lists. Obesity screenings and associated counseling, for one thing, as well as HIV screening for high-risk individuals.
It's easy to wait until something feels or looks wrong before we head to the doctor's office, or even to the ER. However, the copay, deductible, and/or coinsurance would apply to those visits. Going in for preventive services per your insurance's allowable schedule and your physician's recommendation may prevent you from having to have costly follow up. And, if your plan renews or begins after September 23, 2010, there's a good chance those preventive services won't cost you a dime.
Rice Insurance, LLC | 1400 Broadway | Bellingham, WA 98225
Phone: 360.734.1161 | Fax: 360.734.1173