So here’s the first step of employer insurance going away.  imageBoth of these companies are self insured so what a way to kick a lot of the administration out of human resources and save money.  Companies have used similar plans for years to where a dollar amount is give and employees choose from a number of plans with their budget allowed and if more is desired it is available but it comes out of the employee’s pocket to make up the difference with health insurance plans.  Sears and Darden restaurants are trying this out to become effective the first of the year. 

The employees will choose their selections through an “exchange” not to be confused with the “exchanges” that states are setting up.  It sounds like the difference here is that it will be done online imageversus how it has been run in the past and the companies will still have their contracted insurers listed as choices.  Back to the self insured side these are “group” plans so again it is a bit confusing here, but that’s what insurance plans do these days, confuse us.  UnitedHealthcare, Cigna and Health Care Service Corp., which operates Blue Cross and Blue Shield plans will be the choices and a couple others to bring this up to 5.  Interesting to see a subsidiary of Blue Cross in here instead of a direct contract. 

This is kind of a hybrid plan it seems to set up for actual exchanges maybe later on as time moves on.  Again this is not a new concept as companies have had multiple contracts with carriers for years and offered choices.  I had a plan like this 15 years ago with United Healthcare, so I wonder who’s brain child was good guess:)  Now with both employers having been self insured how exactly does this work?  Is the employee now going to deal direct with the insurers they select or will the HR Departments still run the administration of the contracts, or better yet will they hire yet another insurance company to come in an administer for the HR department and could it be one of the companies on the selection list?  Big corporations have been doing that for years with bringing in an insurer to administer the company health insurance plans. 

Will competition help keep the prices down, I doubt it.  The big carriers are still going to go after the government contracts and you see United and Blue Cross duking those out all over the place and appealing decisions and so forth and with the Tri-Care Contract, United Healthcare sued to get that one, so does that always work.

Blue Cross Protesting Award of Texas Employee Retirement Health Plan to United Healthcare–Price Cut by $25 Million With Little or No Out of Network Coverage for Members

State of Louisiana Rejects United Healthcare’s Protest Over Awarding Blue Cross/Blue Shield Contract To Manage State Employee Health Insurance–Battle of the Insurance Algorithms Continues..

With the Tri-Care contract it will end up probably putting the one Blue Cross subsidiary out of business.

Tri-West Won’t Challenge Tri-Care Military Contract Loss To United Health - Legal Decisions & Contract Awards Allow Machines To Move Money for Profit As Company Will Likely Close Down-Subsidiary Watch

Sears also created a new subsidiary this year called Metascale  and they target customers with revenue over a billions such as healthcare to sell data services too.  Sears has been an open userimage of the Hadoop platform for a while now and sells it as well as server space so with all their data capabilities and what they have in resources they have to be cashing in at least making $1 billion a year on selling data as I compare them to Walgreens making just short of $800 million selling data in 2010.  Selling data too is one big reason corporate profits are up for a lot of companies. 

At a time like this with companies getting most data for nothing and huge profits for free with mining data it’s time for an excise tax as we keep paying more, premiums go up, NIH can’t get enough funds for valued research, FDA need money to get drugs and devices approved faster, and so on.  So new choices here and combined with big profits from data mining and selling, that’s how many of these companies are filling the pot of gold as we stand by and watch hospitals close and family practice doctors starting to become extinct.  It all about the business models and algorithms that are so complex that even the likes of Jamie Dimon can’t tell you how JP Morgan works, so this change represents some type of business model that will allow for greater profits and maybe we just can’t see it yet until it rolls out as we always have those unintentional consequences today with most business plans and their math.  BD


One More Good Reason to Tax the Data Sellers– Create Additional Funding for the NIH and FDA From Sources That Otherwise Are Too Greedy to Share & Contribute

The chat on CNBC video is interesting too in the fact that you have 2 financial experts talking about this and they both come right out and say they don’t understand their current plans, so right from the horse’s mouth about choice empowering employees…sounds to me like it’s more to deal with in this already overloaded data world.   BD

Sears and Darden restaurants offering cash to buy their own health plans. the company says it's not to save money. yeah, right. but do give workers more control. i always like that when they put it in there as a more controlled kind of thing. that's not the purpose of an employer, to give you more control. so you know at some level this is about saving money for the company. so what that means is over the long term health care costs are going to shift to employees. this is happening in a lot of big companies. they're considering -- here's what our poll says


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