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Tag: employer-sponsored health plan

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.

Why Employers Must Collaborate On Health Care

To my fellow business owners, this is an excellent read on “Why Employers Must Collaborate On Health Care” by Brian Klepper, originally published in published in the Columbus, GA Ledger-Enquirer on Sunday, 9/15/13:

Excerpt: 
Health care is of course very important. But as has been documented over and over (to no avail), it is out of control, with costs that have become so excessive that they literally represent the greatest threat to our national economic security. At $2.8 trillion per year or about one dollar of every five of gross domestic product, health care has become our largest, wealthiest and most politically influential industry. In turn, this has allowed it to spin every piece of health care legislation to advantage.

Read the complete article here.

Brian Klepper is a health care analyst and the Chief Development Officer of WeCare TLC Worksite Clinics.

 

Why Employers Must Collaborate On Health Care

To my fellow business owners, this is an excellent read on “Why Employers Must Collaborate On Health Care” by Brian Klepper, originally published in published in the Columbus, GA Ledger-Enquirer on Sunday, 9/15/13:

Excerpt: 
Health care is of course very important. But as has been documented over and over (to no avail), it is out of control, with costs that have become so excessive that they literally represent the greatest threat to our national economic security. At $2.8 trillion per year or about one dollar of every five of gross domestic product, health care has become our largest, wealthiest and most politically influential industry. In turn, this has allowed it to spin every piece of health care legislation to advantage.

Read the complete article here.

Brian Klepper is a health care analyst and the Chief Development Officer of WeCare TLC Worksite Clinics.

 

Workplace Wellness: Improving Health and Controlling Health Care Spending

According to the U.S. Department of Health and Human Services, chronic disease is responsible for 7 out of 10 deaths among Americans every year. And we know that the costs associated with treating individuals with chronic conditions account for the majority of annual spending on medical care.

Across the country, more employers are learning how nondiscriminatory employer-based prevention and wellness programs can help improve the overall health of our workers and control health care spending—and the Affordable Care Act is making it easier.

The Cost of Chronic Disease and the Benefits of Workplace Wellness

HHS reports that the cost of treatment for those with chronic conditions like heart disease, cancer, strokes, and diabetes accounts for over 75% of our annual medical care costs. In addition to these direct costs, the indirect costs associated with poor health –such as worker absenteeism, reduced productivity, and disability — may be significantly higher. According to the Centers for Disease Control and Prevention (CDC), these productivity losses due to personal and family health issues can cost U.S. businesses $1,685 per employee per year, or $225.8 billion annually.

To view the final rules related to new incentives for employer wellness programs under the Affordable Care Act, click here.

Click  here to read full article.