During October and November, the MIIA Health Benefits Trust provided members with an overview of the current health insurance landscape, including key challenges and strategies for addressing them.
The workshops — one virtual, as well as in-person meetings in Danvers, Quincy and Worcester — were conducted in partnership with MIIA’s service provider for the past three decades, Blue Cross Blue Shield of Massachusetts.
Presenters covered increasing health care and pharmacy costs, strategies for managing municipal benefits amid the state’s health care reform measures, and employer-shared responsibility rules related to the Affordable Care Act.
Two representatives from Blue Cross — Senior Advisor for Provider Strategy Matt Day and Director of Pharmacy Sales Jessica Chaput — detailed how high-cost claims have increased steadily over time, with a significant jump at the end of 2022 that flowed into 2023. GLP-1 drugs for diabetes and obesity (such as Trulicity, Ozempic and Munjaro) are currently the largest driver in pharmacy spending trends, they noted.
Larry Tereso, MIIA’s vice president of sales and marketing, covered recommended strategies for limiting exposure to ACA penalties intended for employers who fail to offer affordable health care coverage to full-time employees. He said assessing potential penalties can be challenging because municipal employers typically do not have access to household income information. He advises municipal employers to conduct a thorough internal assessment to determine the number of full-time employees whose wages may qualify them for a health care tax credit, ensure that affordable health care is offered, and budget properly for any expected penalties.
Bob Knowles, Blue Cross’s director of municipal sales, noted that MIIA and Blue Cross together have maintained a relationship with municipalities for 32 years, and the partnership remains one of the few stable options for municipal health coverage. More than 150 municipalities in Massachusetts have chosen Blue Cross Blue Shield insurance through MIIA, giving them access to 100% of hospitals around the Commonwealth and 71,000 health care providers.
Municipal leaders can access additional information about MIIA Health Benefits Trust options on the MIIA website. MIIA members should consult with their MIIA account executive for any questions related to ACA rules and penalties.
