Insurance Insights

Four Cost Saving Tips for You

How can you take advantage of health reform’s positives and minimize the negatives? Here are four key recommendations for December. 

 

Do share this information with your employees and friends. Take a look at our new website. We have created a Health Reform section, which we will continuously update with critical information and helpful resources. 

 

1.  Bring back your under 26 year old dependents to your group coverage.

 

Your dependents are eligible to enroll in your health plan at the next open enrollment after September 23^rd, 2010. If you currently have children enrolled in the plan, there will be no additional cost for your older dependents. 

 

2.  Stock your medicine cabinet with over the counter medications this month.

 

December is the last month you can use your pre-tax Flex Spending Account and Health Savings Account funds to purchase over the counter medications.

 

3.  Ask your doctor to write prescriptions for over the counter medications for 2011.

 

Over the counter medications will continue to be eligible for pre-tax purchase if you have a doctor’s prescription. 

 

4.  Make appointments for free physicals in 2011.

 

Very good news! Your preventive health services will be fully covered by your insurance - without any co-pays or cost-sharing. (Check your health plans for list of age-appropriate services). Make your 2011 appointments early. Doctors expect to be busier than ever as patients take advantage of this benefit.

 

Thank you to all!

 

On this, our last post of the year, we wish you all good health and happy holidays. We very much appreciate your business and look forward to ringing in 2011!

Health Care Reform Update Regarding Dependent Coverage

Good news!

 

All those students receiving their college diplomas this May and June, will also receive good news about their health insurance coverage.  California’s major insurers have agreed to implement the provision of the health reform legislation that allows young adult dependents to remain on their parent’s health plans, effective June 1st.  This change is the first major benefit of the Patient Protection and Affordable Care Act.

 

Anthem Blue Cross, Blue Shield, Kaiser, Aetna, Health Net, and Humana will allow currently insured dependents in individual and group plans to retain their coverage up to age 26.

 

We are waiting to receive information on the implementation process.  Blue Shield of Ca. has notified us that your dependent will automatically be allowed to continue on your plan if you are insured in a small business plan.

 

If your family would like to take advantage of the new policy, we advise contacting your insurer to learn what forms are required—and to be sure there are no glitches in this process.

 

Please note that dependents who have already left their parent’s plan and wish to reenroll won’t be able to do so until the date of their plan renewal following September 23^rd.

 

 

How Will Reform Affect My Health Care Costs?

­­­­­­As a small business owner, is health reform going to do anything to make my insurance premium more affordable?  Can I expect any near term cost savings from health reform?

This post addresses a few significant provisions of the health reform legislation and its impact on affordability, premiums and costs. There’s good news and bad news in the next year.

 

1. Review of Health Insurance Premiums and Premium Refunds

The good news is that the legislation sets up federal and state review processes to evaluate health insurance premiums this year. Starting in 2011, insurance companies must pay at least 85% of large group and 80% of small group premiums in claims (across their book of business). Employers will be issued a refund if the insurer pays less than this amount in claims.

2. Small Business Tax Credits for Providing Health Insurance

Effective January 1^st 2010, eligible small businesses and non-profits will receive tax credits to help them pay for providing group health insurance for their employees. Unfortunately few of our clients will benefit because businesses must have average wages of less than $50,000 to be eligible. If you believe that your company may be eligible, please contact us for details.

3. Increased Benefits

The legislation contains significant benefits increases (including expansions in coverage of dependents and preventive care) that will increase short term costs. Please see our last post for more information.

 

What we hope for in the future

We hope that this legislation will be a giant step forward in creating pricing transparency for medical services.

In Massachusetts, a government review has disclosed significant differences in pricing agreements between insurers and medical facilities based on the bargaining clout of the large hospital groups.  In other words, the price of care is based on bargaining power not quality of care or medical effectiveness. Why are we not surprised?!

In 2014, government subsidies will begin assisting lower income families purchase health insurance. These subsidies are funded by our tax dollars; the public has a clear interest in transparent pricing related to medical outcomes.

We develop these blogs in response to your questions.  Keep them coming!

Good News for Employers in 2010!

Small business owners are practical.  Now that health reform has passed, the question is “What’s the good news for me and my employees?” We’ll discuss several of the key provisions of the reform package in each upcoming post. Our goal is to make these changes easy to understand and recommend simple action steps to help businesses prepare. Keep your questions coming!

 

By the way, the changes listed here apply to both group and individual health plans.

 

 1. Expansion of Preventive Care Coverage

 

You and your employees will be fully covered for specific preventive care services with no co-pay. This is a key provision of the reform package—to erase any barriers to preventive health screening. The goal is to identify health problems early. Everyone wins here: we prevent more serious, more expensive health problems. 

 

There will be a list of preventives services that health plans will be required to cover—based on guidelines established by several federal entities.  No more will you be frustrated by the differences in health plans’ definitions of preventive care. 

 

2. Extension of Coverage for Adult Children to Age 26

 

All insurance plans that cover dependents will be required to offer adult children coverage up to age 26.

Currently, children over age 18 must be full time students to be covered under their parents’ health insurance; under the new legislation, adult children are no longer required to be students at all to be covered.  As one of our clients wrote, “now my daughter doesn’t have to take credits she doesn’t need to stay on our insurance. She can work part time, help pay for her education and get valuable work experience.” 

Adult children living at home, on their own, and even those who are married, are eligible. However, those who are offered health insurance through an employer are not eligible.

This extension is expected to significantly decrease the number of the uninsured since young adults make up 30% of the uninsured population.

 

 

When will these changes begin?

 

Here’s where it gets confusing. It’s not the same for everyone. Changes will begin on your first health plan renewal date on or after October 1^st, 2010 because they must be written into your new contract. 

 

 

What should employers do now?

 

Prepare, communicate, and wait for more information. We all know that these additional protections will be paid for by our premium dollars.  Anticipate that premiums will continue to rise and that the cost for dependent coverage, in particular, will be higher. One source has suggested that insurers may set up an additional pricing tier for dependents over age 18 to account for the additional cost to insurers.

 

Review your company policy for employer/employee cost sharing for health premiums, particularly regarding dependent coverage. Consider what changes you may want to make. Wait for more information before finalizing any new company policy. It’s going to be several months before the regulations are written, insurers rewrite contracts, and price the new benefits.  There are bound to be some surprises along the way! 

 

Communicate the good news to employees and alert them to the anticipated effective date of plan changes.  Urge your people to delay making any decisions about their children’s plans, until full information, including cost, is available.

 

We encourage you to share this information with fellow business owners. Please let us know if you would like to arrange a presentation for your business group!