health care costs Archives - Ark Insurance Solutions

Benefits Breakdown

March 22, 2021/by Rebecca Yates

Understanding Prescription Drug Pricing Trends

In 2019, the United States spent nearly $370 billion on prescription drugs, keeping trend with significant increases year over year. Although prescription drug spending has historically been a small proportion of national health care costs compared to hospital and physician services, it has grown rapidly in recent years—comprising about 10% of national health care spending. Below are the two major factors contributing to the rise of prescription drug costs:

Influx of specialty drugs—Specialty medications account for a smaller portion of U.S. prescriptions than non-specialty drugs, yet they command nearly half of the pharmaceutical market. In 2021, experts predict an 11.5% increase in specialty drug prices, compared to a 2.8% rise in non-specialty drug prices. These manufacturer price increases are often cited by insurers as reasons for rising insurance premiums.
Price inflation—According to a Segal report, 40% of new products recently launched by drug manufacturers were specialty medications. These drugs are now being pushed at a higher rate than non-specialty drugs, contributing to price inflation. Specialty drug utilization increased by nearly 6% in 2020, whereas non-specialty drug usage remained relatively the same. And there is little recourse for anyone seeking an alternative to these specialty drugs.

Yet, despite these trends, there are cost-cutting strategies available to employers. These include managing drug usage, utilizing rebates, and educating employees. Reach out to learn more about these and other budgetary tactics.

3 Voluntary Benefits Trends to Watch in 2021

Voluntary benefits have always been great tools for rounding off employee benefits offerings. And that value isn’t lost on employers—at least 50% offer some sort of voluntary benefits, according to an Alera Group report. Employers can expect to see voluntary benefits grow in these three key areas in 2021:

Expanded offerings such as eldercare and critical illness insurance
A focus on financial wellness, including budget counseling and financial planning
Greater customization, allowing employees to pick and choose what’s best for them

Voluntary benefits include dental, vision, critical illness, pet insurance, and similar offerings that are paid for partially by employees. During the COVID-19 pandemic, having additional benefits options like these could be exactly what employees need. Specifically, these trends indicate employees want more control over the benefits that are important to them.

Reach out to learn how to help employees maximize their voluntary benefits.

Benefits and Me

February 18, 2021/by Rebecca Yates

Balancing Caregiving and Your Career

The demands of caregiving and working a part-time or full-time job can leave you exhausted and stressed. When left untreated, chronic stress can develop into serious health problems, including depression, anxiety and cardiovascular disease.

If you are struggling to balance your career with the demands of caregiving, consider the following employer-provided resources:

Shift flexibility—Talk to your manager about how to make your schedule less burdensome by altering your hours or telecommuting.
Employee assistance program (EAP)—Be sure to discuss your EAP options with your HR representative. They will likely be able to chat about care management and determine if your situation qualifies you for any benefits.
Stress management—Talk to your manager and other co-workers about organizing stress-relieving activities at the workplace.

This balancing act between providing care while working full or part-time can be both stressful and exhausting. For additional resources, contact your HR manager.

Lower Your Health Care Costs by Improving Your Well-being

Taking control of your overall well-being can greatly lower your health care costs. Lifestyle changes can help prevent or lessen the severity of health issues, which may result in fewer health expenses and greater well-being.

Consider changes to address components of well-being:

Physical well-being—Stay physically active, eat a well-balanced diet to fuel your body, and get enough sleep each night.
Mental well-being—Find ways to deal with stress, like journaling or meditating, and consider therapy to talk to a professional.
Social well-being—Join a club or sports team to meet new people.

The Basics of FSAs

Flexible spending accounts (FSAs) provide you with a tax advantage to help pay for health care and dependent care. As an employee, you set aside a portion of your pre-tax salary in an account, and that money is deducted from your paycheck throughout the year. Consider the following types of FSAs:

Health care reimbursement FSAs can be used for your deductible, copayments, and eligible health care expenses, including prescription drugs, dental costs, eyeglasses, and contacts.
Dependent care FSAs let you use pre-tax dollars toward qualified dependent care, such as the cost of nursery schools.

FSAs are beneficial if you have out-of-pocket medical, dental, vision, hearing, or dependent care expenses beyond what your insurance plan covers.

Please reach out to one of our agents if you have questions.

Uninsured COVID-19 Patients, Hospital Bills are Covered

January 7, 2021/by Rebecca Yates

Most major health systems around the country are part of a program through the Center for Medicare and Medicaid Services that provide payments for uninsured patients who have COVID-19.

Medical bills are covered through the pandemic legislation relief, the CARES Act.

Patients may not be informed of this upfront; ask the question if it is a concern.

Five Insurance Tips for Millennials

September 4, 2020/by Rebecca Yates

Millennials find themselves in the stage of life that may require them to purchase their own insurance. After having aged out of their parent’s insurance coverage and buying or renting a place to live, coverage needs may not be as black and white as one might think.

Knowing these five tips will help navigate through the sometimes-complicated policies out there.

Shop smart for adequate coverage- Although cost is an important factor, having the coverage you need is equally important. You may be tempted to choose the least expensive plan but when it comes time to make a claim, you will see less of a financial benefit. In fact, a high deductible could cause a unexpected financial burden.
Look for discounts- Often insurance carriers will offer discounts for bundling services, such as your home or rental insurance and your car insurance. In addition, there are discounts for being in school and getting good grades. Be sure to ask your agent about these and other possibilities.
Fill in the gaps- An average policy will provide basic coverage but that may not be enough for all your coverage needs. For instance, a rental or homeowner’s policy may not cover personal items such as jewelry over a certain dollar amount. Be sure to ask if you have collectables or higher value items.
Purchase life insurance- Life insurance is important, no matter how old you are. For a millennial, it may also save you money on a policy in the long run. It is especially important if you have children. Life insurance can help your family cover unexpected costs in your absence. If you have children, a life insurance policy can support their education or child care expenses.
Consult an independent broker or agent- Talking with an independent insurance agent is the first step in finding the coverage you need and can afford. An independent broker works with multiple providers and can help you navigate the different policies and coverage. They can also help explain some of the terms and conditions that may be difficult to understand.

Tip # 3 From the Single Mom’s Guide to Health Insurance- Look at your income and cash flow situation.

February 2, 2020/by Rebecca Yates

There are two basic types of plans.

Traditional plans, which often have low copayments for regular visits, and High Deductible health plans.

Traditional plans are what many people used before healthcare reform. They had copayments
(a small amount due at the time of service) for regular Dr. visits and medications. They have
a deductible and coinsurance for unusual things like MRI’s, CT Scans, and hospital visits.

These plans tend to be more expensive every month, but generally require a smaller portion
to be paid by you when a claim happens.

High Deductible health plans are paired with a tax-protected savings account called a Health
Savings Account or HSA. These plans require that your deductible come first unless it is a
preventive service.

To download the complete guide, click here.

Offering Health Insurance is Good Way to Attract Millennials as Employees

January 19, 2020/by Rebecca Yates

A survey conducted by Anthem Life Insurance Company suggests that one in three millennial workers turned down a prospective job offer either due to insufficient health insurance coverage or none being offered at all.

As more millennials are entering marriage and purchasing homes, etc., concerns are shifting. Disability coverage is now part of the conversation and if employers are not offering it, many potential workers will keep walking. In addition, as millennials begin to start families, health insurance coverage, beyond the basics, is also important. Protecting themselves and their families become the forefront. Vision and dental are no longer looked at as optional add-ons, employees want to know they will have the coverage they need, or a loved might need to ensure peace of mind.

The Anthem survey also found that millennials are more likely than older workers to have engaged in long-term financial planning over the past year. Twenty-nine percent of millennials responded that they have conducted long-term financial planning, compared to 19% of 35 to 54-year-olds. (Anthem Life Insurance Company, March 2017)

You may qualify for health insurance assistance

November 8, 2019/by Rebecca Yates

This post was updated on 12/1/2025

Below is the table that the federal government uses to determine health insurance assistance.

If your income falls between 135% and 400% of the federal poverty level for your family size you may qualify for assistance with your premiums.

Note: Each individual program–e.g., SNAP, Medicaid–determines how to round various multiples of the poverty guidelines, what income is to be included, and how the eligibility unit is defined. For more information about the poverty guidelines visit:

https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines

Source: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.

Huntsman Mental Health Institute Coming to University of Utah

November 5, 2019/by Rebecca Yates

The University of Utah President Ruth Watkins, announced on November 4, 2019 the Hunstman family has pledged $150 million to establish a mental health institute at the University of Utah.

“Suicide is increasing as a cause of death,” said Michael Good, University of Utah senior vice president for health services, CEO of University of Utah Health, and Dean of the University of Utah School of Medicine. “There just aren’t enough mental health professionals. We need to do better. This generous gift from the Huntsman family will allow us to support enhanced training for mental health professionals. It will allow us to reimagine care teams and how to better deliver mental health services across our state and across our region.” (ksltv.com)

The grant agreement also states the university will work with the Huntsman family to raise additional funds to increase community awareness in regards to mental health issues and will also provide financial support to the University Neuropsychiatric Institute (UNI) and to support mental health screenings to the 32,000 students including in rural areas.

Recent Study Looks At Health Care Pricing

May 15, 2018/by Rebecca Yates

According to a recently published healthcare economics paper, different insurers pay varied prices for the same services and procedures at the same hospital, indicating that bargaining leverage really does impact healthcare prices.

Authors took actual data from claims for three national insurers. Studies showed that dominate hospitals can dictate how much they are going to get paid for specific services and procedures. For hospitals that hold an monopoly in their area, that number was 12.5% higher than those who had nearby competitors. For more concentrated markets, providers can shift more risk to insurers, which affects the ability to keep prices at a set standard.

“The two main types of contracts use prospectively set prices that pay a fixed dollar amount based on the DRG classification code, or a model that sets payments as a percentage of hospital charges.
Hospitals are likely to prefer the latter because they get paid for every service they provide, and thus bear less risk. This drives prices up and also places less pressure on the hospital to reduce costs.”

In simply terms, it’s about negotiation. The hospital may charge $50,000 for a hip replacement, but the negotiated price may be more like $22,000, Medicare reimbursements would be even less.

“Researchers also found that prices increased by more than 6% when merging hospitals were less than 5 miles apart. They didn’t find significant price impact when the hospitals were separated by at least 25 miles.”

Sources: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured Zack Cooper (Yale University) Stuart V. Craig (University of Pennsylvania) Martin Gaynor (Carnegie Mellon University and NBER) John Van Reenen (Massachusetts Institute of Technology, CEP, and NBER)

Modernhealthcare.com

Health Care Cost Institute

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