Thursday, May 31, 2012

Webinar on common compliance mistakes and how to avoid them

Please join us for a webinar on common compliance mistakes on June 21st from 1:00-2:30 PM EST.

Reserve your seat now at:

It is helpful to understand compliance areas that have caused real consequences for other employers. In a departure from our normal webinars, which usually deal with a particular compliance topic, this session will review actual cases, and real life examples, of situations where an employer’s compliance mistake caused a problem. Some of these errors resulted in employer fines, penalties or financial liability. In each case we will discuss what when wrong and what could have been done to avoid it. Obviously no names will be used!
Please note: times for AG webinars vary and are listed for the Eastern time zone.

Presented by: Bob Radecki, President, Benefit Comply, LLC
Bob Radecki has more than 30 years’ experience in the HR and employee benefits industry helping employers deal with difficult benefit and compliance matters. Previously, Bob founded and served as President of A.E. Roberts Company, a nationally recognized compliance consulting and training firm. He has served as the principal HIPAA consultant to a number of health insurance companies, and is recognized as an expert on a variety of benefit compliance issues including COBRA, FMLA, Health Reform and more. Bob has been the featured speaker at numerous industry events and conferences, and has published a number of articles concerning various compliance issues.

IRS announces transition relief for non-calendar year FSA plans

Late yesterday, the IRS issued Notice 2012-40, which provides transition relief to non-calendar-year FSA plans by establishing that the requirement does not apply for plan years that begin before 2013 and that the term "taxable year" in the law refers to the plan year of the cafeteria plan as this is the period for which salary reduction elections are made.

This is a change from the initial guidance and will provide the options for plans renewing 6/1/2012 through 12/31/2012 to keep a higher maximum if they wish to do so.  Some FSA administrators may also allow groups that renewed previously in 2012 to increase their maximum above $2,500 and allow employees to change their elections.

Plans will have until the end of 2014 to amends their SPDs to reflect the new maximum.  For plans that have a grace period for their health FSA, any unused amounts that carry over into the grace period do not count against the cap.  The cap only applies to employee salary reduction contributions, and does not apply to employer contributions.  Additionally, the cap is a per-employee cap (rather than a family cap) and each spouse may contribute up to the max whether through the same or different employers.

Thursday, May 24, 2012

UHC Prescription Drug List Update

UnitedHealthcare Prescription Drug List (PDL) Revisions: View the PDL Tracker for a recap of changes outside the January 1 and July 1 pharmacy updates.

UHC Releases MLR Update

UnitedHealthcare has provided an “Early Warning Report” on where medical loss ratio (MLR) rebates are forecasted to be paid to group and individual policyholders. The results indicate that the rebate payout is forecasted to ultimately equal less than 1% of total premium for 2011. View the Group and Individual reports.

Policyholders were aggregated by group size, state of contract issuance and legal entity into Aggregation Sets for the purpose of calculating MLR.

For more information please view the entire article.

Wednesday, May 23, 2012

What The PCORI Fee Means For Your Business

A Patient-centered Outcomes Research Institute (PCORI) fee will be imposed on plan sponsors and issuers of individual and group policies under the Patient Protection and Affordable Care Act. The first year of the fee is $1 per covered life per year, the second year the fee adjusts to $2 per covered life.

The fee, formerly the comparative effectiveness research fee, contributes to the Patient-Centered Outcomes Research Trust Fund that funds research to evaluate and compare health outcomes and the clinical effectiveness of medical treatments. On April 17, 2012, the IRS proposed regulations that provide guidance on calculating and paying the PCORI fee.

The fee applies to certain specified health insurance plans/policies and includes medical, pharmacy, retiree-only, any accident or health insurance coverage (including a policy under a group health benefit plan) issued to individuals residing in the United States.

For more information please view the full article released by UnitedHealthcare.

Friday, May 18, 2012

BCBSNC Collaborates with SAS to Harness the Power of Analytics

Blue Cross and Blue Shield of North Carolina (BCBSNC) and SAS announced that they are collaborating to help health plans provide better, more personalized care and service to customers while holding down costs for individuals and employers. This new software from SAS will help health plans in creating products and services that are better matched to consumers' specific health needs.

“In an industry that has not used insights to their fullest potential, BCBSNC and SAS are blazing a path to the future of health care. This SAS software will provide health plans with predictive models similar to those in other consumer-focused industries,” said SAS Chief Medical Officer Dr. Graham Hughes. “By better engaging customers, health plans can provide top-notch customer service and support. This will allow the health system to deliver consumer-focused patient care. Better care often means reduced costs – the health plan wins, the provider wins. Most importantly, the customer wins.”
For more information please view the full article.

Monday, May 14, 2012

UHC New Healthcare Cost Estimator Now Available to Members in Select Markets

UnitedHealthcare has released the new myHealthcare Cost Estimator (myHCE) giving UHC members personalized provider and facility-specific medical cost estimates for high-cost, common procedures and treatments based on members specific medical plans.

myHCE enables UHC members to make a personal value choice-based on cost, quality and convenience with consistently reliable cost estimates.

Key features and functions include:
  • Physician and facility specific medical cost estimates
  • Personalized benefits information and current health status per the member's plan design
  • Consumer health account balances with OptumHealth Bank (HSA/HRA/FSA)
  • Service-specific health content, financial guidance
  • 100+ lab, radiology/imaging, physician and outpatient services
This tool will be available in three North Carolina markets including Charlotte, Raleigh/Durham, and Wilmington on May 31, 2012. Follow this link to view a complete list of select markets this tool will be available in.  For more information on how this new tool can serve your employees you may view the entire article.

Thursday, May 10, 2012

UHC Pharmacy InFocus Newsletter

UnitedHealthcare has released their latest pharmacy newsletter, Pharmacy InFocus. This newsletter features updates on the OptumRx transition, diabetes drug changes with Advantage PDL, and new pharmacy informational videos.

IRS Announces 2013 HSA Adjustments

What’s new for 2013? HSA contribution limits, HDHP minimum deductibles and out-of-pocket maximums will increase.

HSA Contribution Limits:
•Individual (self-only HDHP): $3,250($150 increase from 2012)
•Family: $6,450 ($200 increase from 2012)

Limits for catch-up contributions (for persons over age 55):
 $1,000 (unchanged from 2012)

HDHP Minimum Required Deductibles:
•Self-only: $1,250
•Family: $2,500

HDHP Out-of-Pocket Maximum:
•Self-only: $6,250 (a $200 increase from 2012)
•Family: $12,500 (a $400 increase from 2012)

For more information view the IRS Change.

UHC Plan Participants to Have Access to Care Provided by Vidant Health

Beginning June 1, 2012 people enrolled in UnitedHealthcare employer-sponsored, individual, and Medicare plans will have access to Vidant Health physicians and facilities in eastern North Carolina.

Vidant Health's facilities include Vidant Medical Center, Greenville, NC; Vidant Beaufort Hospital; Vidant Bertie Hospital; Vidant Chowan Hospital; Vidant Duplin Hospital; Vidant Edgecombe Hospital; The Outer Banks Hospital; Vidant Pungo Hospital; and Vidant Roanoke-Chowan Hospital.

For more information view full press release.