A highlight from Employee Health Benefits in 2021

OC Talk Radio


I'm proud to bring in the mover shakers difference makers who are passionate about sharing what they've learned. And what you need to know today and today. I'm pleased to have in studio paul a a name. You may be familiar with. I was trying to is trying to pronounce it. It's a it's it's a handful there. I wasn't handful. Let's welcome to the show. Tim zandbergen of fm benefits. Tim welcome to the show. So i think we should probably classic clarify so that everybody knows that we are not distant cousins. We are not father son. We are actually brothers. Who actually wants works together in the field of employee benefits. Many many many many all right. Now who's the baby brother. Who's the elder. And that's all i can't tell here. Well that's that's for for us to know and for okay all right so in any event so tim world of employee benefits. Things have changed since. I got out of that business many years ago and things are changing. I know every year we had obamacare years ago on. We'll talk just about that just a little bit. You say that We mentioned that things haven't really changed their much and But at least will give people an idea of what it is There seems to be a constant complaint of my premiums have gone up And that goes on every every year in and discuss what's happening there what's going on with the carriers and also clarify that. Your specialty is in employee benefits so not individual but for businesses small to medium size businesses. Who are providing medical insurance to their staff correct. I do little individual little medicare but for the most part is employee. That's right well you open yourself up. We may have to talk about medicare some careful what you say. I said a little all right. So let's talk about what's happening in the world of group medical insurance today. Yes so just look back. As far as the benefits and then what rolled out in twenty fourteen infamous obamacare the affordable care act. It's been six years in the making six years out there and there were four is still being questioned. That's ever going to happen. Yes the rates Benefits continues to be solely. Took away a little bit less enemy year. It's usually single digit increases on the benefits and same time as she made on the costs and the ethics Seemed to decrease elaborate as well are that is meant as trying to manage costs of the carriers try to keep the premium down by pushing more costs onto members as pets so there's typically and as an employer myself we see. There's a tradeoff right. So if there's a an effort to keep in premiums the same is usually a reduction in benefit. That's still seems to be the the game correct. Yes has cracked so what has Port can people expect this year there. Any significant changes twenty. Twenty one is bringing on still single digit increases if they've been in the market now. Small groups owed small group is defined as ninety nine or less employees so those are the groups that really by obamacare they are no longer medically underwritten. Does rates are driven by their age and employers code groups over a hundred more or more medically underwritten and More still made the the old way or pre obamacare when they're metal medals rid and the cost and benefits are designed by the employer of the benefit design. Employer cost is will use ation group with a lot of claims. That group has been a more than another groups Claims one for one hundred more correct correct so under a ninety nine basically carriers have divided up California divide up to nineteen regions. Orange county's number eighteen to curious. Now they rate their cost of doing business in the region so in orange county where the call was. It costs for anthem blue cross. Ucla california to business in orange county at premiums coming in versus money going out paying claims. And that's how some of the rates are generally anything different in twenty twenty one with regards to the design of plans or anything added anything taken away. Now they're still Tears so platnum is the best gl silver and bronze stay still use them talent Schedule and the benefits are still defined by

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