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Tag: Employer Group

Employer reporting….more guidance

Carriers often release alerts or guidance on specific issues on health care reform. Cigna released guidance on Minimum Essential Coverage reporting requirements.

Minimum Essential Coverage (MEC) reporting is required to help the Internal Revenue Service (IRS) administer compliance with the individual mandate. All insurers and self-funded group plan sponsors are required to start reporting on the individuals covered under their insured health plans, starting with coverage in 2015. While these reporting requirements do not begin till 2016 for the 2015 year, certain components of the law require actions this year.

Because Social Security Numbers (SSNs) and Tax Identification Numbers (TINs) are the main individual identifying data used by the IRS, reporting entities are required to make “reasonable attempts” to obtain this sensitive data from those individuals’ whose SSNs/TINs they don’t have on file.

“Reasonable attempts” are defined as three attempts to obtain the SSN/TIN, and may include electronic, paper, telephonic, etc. outreach*. These attempts must be made by certain dates, starting this year. The outreach is only to each employee or subscriber and their dependents whose SSN/TIN the reporting entities (fully insured business and the client for self-funded business) don’t have, starting with those enrolling/enrolled in 2015 coverage. For example:

  • First Attempt:

o    Current or previous enrollment can satisfy the first attempt, if applications have or had space for each employee and dependent to provide their SSNs/TINs. Enrollment forms often do request the SSN.

o    If current or previous enrollment does not solicit SSN/TIN, a separate outreach must be made in 2014 to obtain employee and dependents’ SSNs/TINs. Since enrollment forms may request the SSN, this separate first attempt is not required for our customers covered under fully insured plans.

  • Second Attempt

o    A separate outreach must be made before December 31, 2014

  • Third Attempt

o    A separate outreach must be made before December 31, 2015

If the SSN/TIN is not obtained after making the three attempts, reporting entities may use the date of birth for any of those covered individuals.

AAPPO Study: Consumer-Driven Health Plans Grew By 15 Percent Last Year

Enrollment in consumer-directed health plans (CDHPs) grew by 15 percent in 2013, according to a survey released today by the American Association of Preferred Provider Organizations (AAPPO).

Enrollment in the plans – which include health savings accounts, health reimbursement arrangements and flexible spending accounts – grew from 39 million in 2012 to 45 million in 2013, according to an AAPPO analysis of the Mercer National Survey of Employer Sponsored Health Plans.

“As major changes to the health system loomed last year, employers continued to look to consumer-directed health plans to offer the affordability, flexibility and stability to ensure their workforces get the care they need,” said Karen Greenrose, AAPPO President and CEO.

Among the survey’s findings:

– 23 percent of all employers offered CDHPs last year – up from 22 percent in 2012.
– 39 percent of large employers (500 or more employees) offered CDHPs in 2013 – up from 36 percent the year before.
– 23 percent of small employers offered CDHPs – up from 22 percent in 2012.
– 63 percent of the largest employers (more than 20,000 employees) offered CDHPs in 2013 – up from 32 percent.
– 35 percent of all employers expect to offer CDHPs in 2016, with 64 percent of large employers expecting to offer them.

The increase continues represents a more than doubling of employers that offer CDHPs since 2008 – from 10 percent in 2008 to 23 percent.

“Consumer-driven health plans offer patients more control over how their health dollars are spent while providing employers more affordability and stability in the cost of covering their workforces,” said Rep. Cathy McMorris Rodgers (R-WA). “In a challenging health care environment, these plans and the PPO networks they are built on provide a strong foundation for affordable care.”

To view the entire study – along with an infographic and video about the report, visit:
http://aappo.org/Resources/Research.aspx.

About the American Association of Preferred Provider Organizations (AAPPO)
Founded in 1983, AAPPO (www.aappo.org) is the leading national association of preferred provider organizations (PPOs). PPOs put control for medical decisions in the hands of the physician and patient, resulting in easy access to the right care, provided by the right doctor, at the right time. AAPPO creates a forum for discussion and dissemination of PPO best practices.

SOURCE: American Association of Preferred Provider Organizations

Read full report here.

Contact Steven Cosby with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

Senate Approves VA Reform Bill

The Senate on Wednesday overwhelmingly approved broad reforms to the Department of Veterans Affairs less than two weeks after a health care scandal led to the resignation of VA Secretary Eric Shinseki.

The unusually swift bipartisan passage spoke to the alarm lawmakers felt when reports revealed tens of thousands of veterans waited months for doctor appointments. The problems were worsened by agency employees who created false waiting lists to try to hide the crisis.

The bill makes it easier for the VA secretary to fire executive employees, creates 26 new VA medical facilities around the country, and authorizes $500 million for the hiring of new doctors and nurses.

It allows veterans waiting for care to go to private physicians and send their bills to the VA, among other provisions.

Read full article here.

Contact Steven Cosby with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

The White House’s Five Most Egregiously Unilateral Changes to Obamacare

It’s above my pay grade to weigh in on the national security ramifications of President Obama’s release of five Guantanamo Bay detainees in exchange for American soldier Bowe Bergdahl. Likewise, I don’t pretend to be an expert on the law, but am willing to take CNN Senior Legal Analyst Jeffrey Toobin’s assertion that the president ”clearly broke the law” in doing so. This unequivocal conclusion was echoed by George Washington University law professor Jonathan Turley.

This matter wouldn’t seem to have much to do with health policy, except that as Professor Turley points out, “to make matters worse, this is a long series of violations of federal law that the president’s been accused of…This is going to add to that pile.” While I certainly don’t maintain a master list of the president’s long series of law violations, my impression is that the numerous law violations surrounding the lawless rollout of the the health care law likely constitute a non-trivial fraction of the total. Indeed, so far there have been at least 23 major changes to the law made through unilateral executive action.

Read full article here.

Contact Steven Cosby with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.