Employer-sponsored health plans spend over $5 on healthcare benefits for every $1 lost in tax revenue due to tax exemptions, which demonstrates the advantages of employer-sponsored health plans for...
Gross margins and medical loss ratios from 2020 may confirm that payer profitability increased during the coronavirus pandemic, according to a brief from Kaiser Family Foundation.
The researchers...
Although utilization has started to return to normal levels, payers have continued making a profit during the third quarter of 2020, a Kaiser Family Foundation brief discovered.
“In this brief,...
CMS has proposed diminishing federal exchange fees in order to lower Affordable Care Act premiums on the federal exchange platform. This proposal comes as part of the 2022 payment...
The Government Accountability Office (GAO) has released a report finding high market concentration across the payer industry and that having increased health plan options does not necessarily reduce...
Compared to 2019, the fully-insured group health insurance markets and Medicare Advantage markets have seen their margins increase and loss ratios decrease in the first half of 2020, with Medicare...
Since the passing of late Supreme Court Justice Ruth Bader Ginsburg, many have questioned whether the Affordable Care Act is at risk of being overturned, a potentiality that would be extremely...
Major payers are beginning to send out individual and small group rebate checks for 2019, providing some financial relief for members, as the Tennessee Department of Commerce and Insurance...
Smoking can lead to higher premiums, a recent study on the tobacco surcharge and tobacco users’ Affordable Care Act marketplace premiums revealed.
According to the Centers for Disease Control...
New York has announced 2021 premium rates and the state appears to be following CMS’s lead for 2020 rates by keeping 2021 rates low.
The New York State Department of Financial Services announced...
As major payers release their second quarter earnings reports, policymakers are growing wary of the skyrocketing revenue, culminating in the House Committee on Energy and Commerce’s investigation...
The Centers for Medicare and Medicaid Services (CMS) announced that it will allow payers to use premium credits to temporarily lower the individual and small group exchange premiums for...
The blow to employer-sponsored plans in the final three quarters of 2020 could be lower than anticipated largely because coronavirus impacts have concentrated on lower income populations, Robert Wood...
Over half of the public rate filings from payers on the individual and small group health insurance market are proposing 2021 premium rates changes between a two percent decrease and a six percent...
With New Jersey’s small group health insurance market in decline, the New Jersey Health Care Quality Institute (Quality Institute), a nonpartisan group that advocates for collaboration among...
The medical loss ratio is a financial standard that plans on the Affordable Care Act exchanges must uphold. It sets the baseline for how much of payer revenue must go directly toward covering consumer...
Business decision-makers on the small group health insurance market are prioritizing health insurance benefits and reconsidering plans with which they currently have contracts, a recent survey by Cigna...
Priority Health and Cigna are creating a strategic alliance to offer greater in-network options for employer-sponsored health plans in Michigan, the payers announced.
“This Strategic Alliance...
Update 5/22/2020: This article has been updated to reflect that the one-sided risk corridor in the HEROES Act applies to individual and small group markets as well as self-insured and large group...
Private payers could issue a total of $2.7 billion in medical loss ratio rebates in 2020, more than double the previous year’s record high of $1.4 billion, according to estimates from the Kaiser...
