Monday, October 31, 2011

Webinar on employee benefit plan discrimination testing

Senn Dunn invites you to participate in an Assurex Global webinar on November 17 from 1:00 to 2:30 PM EST.

Reserve your seat now at:

Employers who sponsor health and welfare plans for their employees are subject to a number of discrimination rules and tests. Depending on the type of benefits offered, as many as 11 different rules and tests could apply to a particular employer:

• Three (3) Section 125 Discrimination Tests
• Four (4) Section 129 Dependent Care Account Tests
• Two (2) Section 105(h) Health Plan Tests
• Two (2) Section 79 Life Insurance Tests

Furthermore, the IRS is expected to soon release the new non-discrimination rules similar to the §105(h) which will apply to fully-insured health plans.

This session will help employers understand what tests and discrimination rules apply to their particular situation and review the basics of each test.

Please note: times for AG webinars vary and are listed for the Eastern time zone.

Presented by:Fritz Hewelt, Principal Consultant, Benefit Comply, LLC
Fred W. (“Fritz”) Hewelt brings over thirty years of experience to his clients, assisting them with a broad range of issues related to the evaluation and remediation of employee benefit and human resource compliance challenges. Fritz has also assisted numerous clients with welfare benefit plan due diligence in merger and acquisition situations. Fritz holds a BS in Business Administration from Elmhurst College, Elmhurst, Illinois. He also has earned designation as a Chartered Life Underwriter (CLU), a Certified Employee Benefits Specialist (CEBS) and a Fellow, Life Management Institute (FLMI).

Friday, October 21, 2011

BCBSNC to mail employers survey for medical loss ratio reporting

The Patient Protection and Affordable Care Act (ACA) requires health insurance issuers to submit a medical loss ratio (MLR) report to the Department of Health and Human Services annually beginning June 2012, and requires the insurer to issue rebates if the MLR is less than the applicable percentage established in the ACA. ACA requires a minimum MLR of 80% for individual and small group plans and a minimum of 85% for large group plans.

BCBSNC currently classifies plans based on number of eligible employees. Plans with eligible employees of up to 50 are classified as small groups, consistent with state law. Per recent federal guidance, BCBSNC must determine group size when calculating MLR by averaging the total number of all employees employed on any business day during the preceding calendar year. This includes each full-time, part-time and seasonal employee that receives a W-2 and excludes temporary employees and consultants with compensation reported on a 1099. This creates a need to collect group size information for MLR reporting purposes which differs from information BCBSNC collects for rating purposes.

Currently, BCBSNC does not collect data on ineligible employees, such as part-time or seasonal workers. To obtain this information, BCBSNC will send mailings to employers with 10 to 50 employees on their group plans, beginning on October 28th.

The instruction letter requests that the employer log into a website to complete the short survey. Or, the employer can complete the survey at the bottom of the letter and fax the letter back to BCBSNC.

Monday, October 17, 2011

HHS will not implement CLASS Act of PPACA legislation

On Friday, HHS Secretary Kathleen Sebelius released her recommendation to halt implementation of the CLASS Act, the long-term care insurance plan included in the health reform legislation passed in March of 2010.  Sebelius stated that the program was said to have design and financial problems and that it could not be implemented in time to launch next year as intended.

The CLASS Act was designed to be an optional, government-backed, long-term care insurance program that required a five-year vesting period before subscribers could collect benefits.

For more information, refer to the Memo from Secretary Sebelius or the HHS Report Analyzing CLASS Act Implementation Options.

UnitedHealthcare's new Prescription Drug List (PDL), effective January 1st

UnitedHealthcare (UHC) has released its PDL and benefits coverage updates for their Advantage and Traditional PDLs, which will be effective January 1, 2012.

To see the PDL changes, refer to the Advantage PDL and Benefit Plan Updates Summary.

Members taking select maintenance medications impacted by a change will receive a letter in December; lower cost alternatives may be listed. For certain changes, UHC will also be communicating with physicians and pharmacies.

Friday, October 7, 2011

BCBSNC & UNC Health Care release details on new medical practice for members with chronic conditions

On October 6th, BCBSNC and UNC Health Care announced that Dr. Thomas K. Warcup will serve as the medical director for Carolina Advanced Health.  Carolina Advanced Health is a first-of-its kind practice that will provide care for over 5,000 BCBSNC members with chronic conditions.  The practice will be located at the Quadrangle Office Park in Chapel Hill and is set to open in late 2011.

For more information, please see the Press Release and FAQ from BCBSNC.

Wednesday, October 5, 2011

Webinar Update on HIPAA Privacy for Employer Sponsored Health Plans

Senn Dunn invites you to participate in an Assurex Global webinar on October 27th from 12:00 to 1:30 PM EST.

Reserve your seat now at:

HHS has proposed changes to the HIPAA privacy rules that could have a significant impact on employers who maintain electronic employee related information. The proposed rules expand the HIPAA disclosure accounting requirements and create a new “access report”.

HHS has also stepped up enforcement of HIPAA, as required by HITECH. Now is a good time for employers to take stock of their current HIPAA policies and procedures, and learn about the impact the proposed changes may have on their plans.

Presented by:  Mark Hoaglund, Principal HIPAA Consultant, Benefit Comply, LLC
Mark Hoaglund is the principal HIPAA consultant for Benefit Comply, LLC. Previously Mark provided HIPAA support and consulting to employers and insurance organizations though his affiliation with HIPAAanswers, and has helped more than 200 companies with their HIPAA compliance needs. Before becoming a HIPAA Compliance Specialist, Mark worked in the technology area for Fortune 500 companies including Pillsbury and Honeywell as a Senior Manager and Project Manager. He has extensive experience with Data Security and Security Management. Mark held lead positions in application development, application support, and computer operations.

After registering you will receive a confirmation email containing information about joining the Webinar.