Actual Small-Group Health Premiums Rise 6.1%

Small-group health insurance premiums are still going up at about the same rate as before, and the enrollee count continues to fall. The average monthly premium increased 6.1% in 2024, to $659. The rate of increase was down, slightly, from 6.2% in 2023.

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GLP-1 Drugs Need Price Cuts To Be Financially Viable, Researchers Say

The new-generation weight-loss drugs work very well at preventing obesity, diabetes and death, but they are still much too expensive to be a good financial value for employer plans or other payers, researchers report in a new paper published by JAMA Health Forum. Semaglutide, the GLP-1 agonist drug that powers Wegovy, could cost less than $100,000 per ...

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Congress Must Reject Taxing Employer-Provided Health Care Coverage

As the new Congress and administration are settling in, all eyes in Washington are focused on the trillion-dollar question: whether and how to pay for the expiring provisions of the 2017 Tax Cuts & Jobs Act (TCJA), signed into law in President Trump’s first term. Among the various revenue-generating proposals emerging from GOP circles — ...

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ACA Changes Could Impact Employer Plans, Individual Coverage Reimbursements

Managers of the Affordable Care Act public exchange system want HealthCare.gov and the state-based exchanges to tighten up. The Centers for Medicaid and Medicaid Services, the federal agency that oversees the ACA exchange system, hopes to make all ACA public exchanges start their annual open enrollment periods Nov. 1 and end the open enrollment periods ...

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No Data, Higher Premiums: Insurance Industry Braces For Fallout From Government Cuts

The insurance industry relies on a steady flow of publicly available data to predict losses, price policies, and mitigate financial exposure. What happens when those data streams dry up? We’re on the verge of finding out. Recent governmental workforce reductions, agency closures and “streamlining” initiatives fostered by President Donald Trump, his unelected advisor, Elon Musk, ...

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Blue Shield Of California CEO Exits After 2 Months

Blue Shield of California CEO Lois Quam is stepping down after two months on the job. The nonprofit health plan will begin a search for a permanent CEO and has appointed CFO Mike Stuart as interim president and CEO, according to a March 11 news release. Mr. Stuart was appointed Blue Shield’s CFO in 2022 and previously ...

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Company Sold ‘Sham’ Health Insurance In California, Must Return $800k To Customers CA DOJ Says

Two companies have agreed to a $1.3 million settlement after they were accused of selling “sham” health insurance plans, the California Department of Justice said. According to the CA DOJ, Sedera, Inc. and Sedera Medical Cost Sharing Community, LLC (SMC) billed customers monthly in exchange for the payment of medical services, a plan which they ...

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Dr. Oz, With A TV Host’s Flair, Promises Simple Solutions For America’s Health Care Ills

Dr. Mehmet Oz, President Donald Trump’s pick to oversee Medicare, Medicaid and Obamacare, told senators a combination of investments, technology, and regulatory changes could both bring down costs and make America healthy again. “We have a generational opportunity to fix our health care system and help people stay healthy for longer,” Oz told senators on ...

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CAA Pharmacy Rx Data Collection (RxDC) Compliance Requirements Due by 6/1

The Consolidated Appropriations Act (CAA) of 2021 introduced a complex set of transparency-related compliance requirements for health plans, insurance issuers, agents, and providers – all designed to improve clarity and accountability in health care. One of the CAA’s key transparency initiatives is the annual Rx Data Collection (RxDC) reporting requirement, which mandates that health plans and ...

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The Good News About Anxiety

The first time my improv teacher called me up to act out a scene, my throat clenched and my vision briefly went dim. The thought of performing in front of other people, especially in a way that was meant to be silly, sent my anxiety into the stratosphere. I had signed up for improv to ...

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