Medical Loss Ratio: What does it mean?

If you’re an employer, you probably saw a rise in healthcare costs this year, but the rise for 2012 is lower than it has been. One reason may be the Medical Loss Ratio (MLR) provision of Healthcare Reform that requires insurers to spend at least 80-to-85 percent of premium dollars on healthcare services and healthcare quality improvement.  If the insurance carriers do not meet this new requirement, they will be required to refund excess premiums to policyholders.

The other 15-to-20 percent insurance carriers may use for programs like education, prevention, overhead and even administrative systems that make healthcare more efficient. With the 80/20 budget requirements, insurers have redesigned their plans, cut broker commissions, and began looking for new ways to improve profitability.

With higher healthcare costs trickling down to business owners, some employers are less able to provide benefits to their employees. As a business owner, you recognize the benefits of providing health insurance for your employees, so what can you do?

Despite the uncertainty, working with a partner that has a clear vision of the legislative and economic environment can help you find a plan that is a) in line with your budget and b) ensures that your employees are still well taken care of.

We’ll continue to watch this issue and advocate for employers as legislation moves forward.

Long-Term Care: Who’s Footing the Bill?

How many of you have health insurance? Life? Disability? What about long-term care insurance? Considering that half the money you will spend on medical care for your lifetime is spent in the last two-to-three years of life, overlooking long-term care coverage can be financially devastating.

Long-term care provides personal assistance when someone can no longer care for themselves—not to be confused with long-term disability, which stops after age 65 (watch this video to learn more about the differences).

There are more than 50 million Americans today providing unpaid care for family members and loved ones, a huge expense to shoulder. Custodial care (feeding, bathing, dressing, transferring) in a home setting, nursing home or assisted living facility is not covered by health plans or Medicare, and these expenses can add up to tens of thousands of dollars over a few short years.  Long-term care insurance can cover those out-of-pocket expenses should you or a loved one need custodial care.

The government’s attempt to address long-term care, the CLASS (Community Living Assistance Services and Supports) Act, was recently repealed as part of the health care reform due to a lack of financial sustainability; however, the urgency of long-term care has not changed. The government was unable to address this issue, but that doesn’t mean it’s out of reach for you.

At Moore Benefits, we offer a range of long-term care plans for groups as low as 15 people. Plans are portable and coverage can be extended to family members (grandparents, parents, spouses, adult children, etc.).

Interested in learning more? Our team is happy to answer any questions you might have about putting a long-term care plan in place for you and your employees.