Monday, July 30, 2012

BCBSNC: Recent Email Scam May Target BCBSNC Customers

BCBSNC wants to make you aware of an email scam that has recently come to their attention.

You or your employees may receive an email from “Message Center” with the subject line “[Your First Name], a thank you from Blue Cross Blue Shield Of North Carlina.” Do not open this email, or if you open it, do not click on any links within it.

The body of the email tells the recipient “On behalf of Blue Cross Blue Shield Of North Carlina you have been issued a $1,000 Visa Gift Card free of charge.” The link included has been associated with malware/spyware and can be a threat to your computer or your corporate network.

Note that “Carolina” has been misspelled: misspelled words are common red flags that can indicate email scams.

With this and any email you receive, it’s important to maintain safe online practices. Please be vigilant to ensure that these types of emails do not harm you, your computer or your corporate computing network.

Webinar on 2012 & 2013 health reform provisions

Join us for a webinar on Thursday, August 23rd, at 3:00 to 4:30 PM EST to reveiw the current health reform provisions for 2012 and 2013.

Click the link below to reserve your seat EARLY:
https://www1.gotomeeting.com/register/221180817

Now that the Supreme Court has ruled on the ACA, employers must make sure they are implementing the necessary measures to comply with rules and regulations which go into force in 2012 and early 2013. This session will help employers understand exactly what is on their “to do” list over the next few months. Topics we will cover include:

• Summaries of Benefits and Coverage (SBC)
• W-2 health plan reporting for the 2012 tax year
• Health FSA $2500 limits in 2013
• How to handle Medical Loss Ratio (MLR) rebates
• Notice of exchanges and subsidies to employees due in March 2013
• Paying the comparative effectiveness research fee
• Review any new regulations released

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.

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

Friday, July 27, 2012

Webinar on Supreme Court Decisions

Join us for a webinar on Thursday, August 9th, at 2:00 to 3:30 PM EST to reveiw the implications of the Supreme Court's ruling on health reform.

Click the link below to reserve your seat EARLY:
Thu, Aug 9, 2012 2:00 PM - 3:30 PM EDT

The Supreme Court decisions on health reform issues are expected in late June or early July 2012. This webinar will review the decisions and discuss the impact on the future of health reform with a focus on how employers may, or may not, be effected by the decisions.

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.

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



Monday, July 23, 2012

UHC: myhc.com sweepstakes

UnitedHealthcare is giving away more than 250 health and wellness prizes to members who register and enter the myuhc.com sweepstakes!

These prizes include Horizon Fitness treadmills, elliptical trainers and exercise bikes, Fitbit wireless activity trackers and Xbox 360+Kinect video game consoles!

The myuhc.com member website allows members to find a doctor, estimate treatment costs, check claim status and history, and track and manage your personal health, either at myuhc.com or through UnitedHealthcare Health4Me App for iPhone and Android.

Members can also view health plan ID card, request a replacement for a lost card, and access a broad range of information designed to help members make healthy choices. To learn more view the attached flyer or visit myuhc.com.

BCBSNC: Launches GO NC!

Blue Cross Blue Shield of North Carolina (BCBSNC) is launching Get Outside North Carolina! (GO NC!) with the goal of building healthier communities across North Carolina. This four-year initiative will start by supporting biking and greenway projects to increase outdoor physical activity. Future efforts will include support for outdoor initiatives across the state that encourage people to get moving.

For more information, please read the statewide press release as well as the Charlotte, NC area press release.

UHC: myuhc.com Member Incentive

UnitedHealthcare members can qualify for a gift card by taking the Race, Ethnicity and Language Preference survey. Learn More.

UHC: African-American Marketing Initiative

UnitedHealthcare announced its Generations of Wellness program aimed at promoting good health for African Americans through its "Healthy Living Challenge." Please follow the link above for more information.

UHC: Pharmacy Updates

UnitedHealthcare released the following three pharmacy updates. For more information please follow the links below.
  • Pharmacy Hot Topics: Get up to date on what the Supreme Count ruling means for you, upcoming contraceptive changes and other important pharmacy news from UHC's latest issue of Pharmacy InFocus.
  • Generic Lipitor Moves to Tier 1: On June 1, generic Lipitor's six-month period of limited competition expired resulting in decreasing the generic's overall price and moving the medication to the lowest tier. Read how UHC notified affected members.
  • PDL Updates: View the new PDL Tracker for a recap of changes outside UHC's January 1 and July 1 pharmacy benefit updates.



UHC: Employer SBC Guide Now Available

UnitedHealthcare has released, An Employer's Guide to the Summary of Benefits and Coverage (SBC). This document contains guidance for creating and delivering SBCs.

Wednesday, July 18, 2012

Medical carriers set to issue MLR rebates to employers

The Affordable Care Act (ACA) requires health insurance issuers to spend a minimum percentage of their premium dollars on medical care and health care quality improvement. This percentage, or medical loss ratio (MLR), is 85 percent for issuers in the large group market and 80 percent for issuers in the small (< 100 employees) and individual group markets. Issuers that do not meet the applicable MLR standard must provide rebates to consumers.

The MLR requirements, which are enforced by the Department of Health and Human Services (HHS), became effective for issuers in 2011. Rebates must be paid by August 1 following the end of the MLR reporting year. Thus, issuers are required to pay rebates by Aug. 1, 2012, based on their 2011 MLRs.

UnitedHealthcare and Coventry Health Care of the Carolinas (formerly WellPath) are two medical carriers in North Carolina that will be issuing MLR rebates for 2011.  Both carriers have stated that employers will receive rebate checks prior to August 1. 
 
The DOL has provided guidance on whether the rebate is a plan asset and how the rebate should be used by employers.  This guidance is summarized in our legislative brief, How Employers Should Handle MLR Rebates.
 
For specific questions on your company's rebate, please contact your team at Senn Dunn.

Tuesday, July 17, 2012

BCBSNC: Understanding Health Care Reform

Blue Cross Blue Shield of North Carolina (BCBSNC) released the attached guide to assist members in understanding Health Care Reform, also known as the Affordable Care Act.
This publication is for information purposes only. It is not legal or tax advice and is not contractually binding on BCBSNC. Please consult with your attorney or tax advisor for further advice.
As regulations and other interpretive guidance are published, this information may change. For specific benefits and contractual obligations, refer to the BCBSNC benefit booklet and/or contract with BCBSNC.

Monday, July 2, 2012

Supreme Court Rules Affordable Care Act Constitutional

The Supreme Court has upheld the constitutionality of the so called “individual mandate” contained in the Affordable Care Act (ACA). In a split 5-4 decision, the court has ruled that it is constitutional for the government to require individuals to maintain health insurance or pay a tax if they fail to do so. Since the individual mandate was held to be constitutional, the court did not need to rule on issues related to the rest of the law. Consequently, by taking this position on the individual mandate, the court has affirmed that the entire ACA is constitutional, other than a particular provision related to Medicaid expansion, as explained below.

MEDICAID EXPANSION
The ACA expands Medicaid eligibility to anyone with an income of less than 138% of the Federal Poverty Level (FPL). The federal government will initially pay 100% of the costs of newly Medicaid eligible individuals. States will be responsible for 10% of those costs in future years. Under current ACA rules, states are required to accept expanded Medicaid eligibility or risk losing all federal Medicaid funding.
In a separate portion of the decision, the court ruled that the federal government cannot deny existing Medicaid funds to states that choose not to participate in the Medicaid expansion. This creates an opportunity for individual states to opt out of the expansion without losing existing federal Medicaid funding.

EFFECT ON EMPLOYER SPONSORED PLANS
The decision by the court means that the elements in the ACA which directly impact employer sponsored plans remain in force. Employers will need to implement requirements such as distribution of the new Summary of Benefits and Coverage (SBC), and the limit on health FSA elections scheduled to go into effect in the upcoming months. We also expect regulatory agencies to move forward with pending guidance such as the IRS’s proposed alternative definition of full time status.

BCBSNC Update on Pharmacies Dispensing Extended Supplies of Medications

On June 4, Blue Cross Blue Shield of North Carolina (BCBSNC) notified members whose pharmacies had not yet signed a contract with Prime to dispense greater than a one month supply of a medication. Most of these pharmacies have since signed the necessary contracts to dispense up to a 90 day supply of a medication. During the week of June 25, BCBSNC mailed the attached letter to approximately 8,800 members whose pharmacy is now able to provide these extended supplies of medications. (Approximately 11,500 members received the first mailing.) 
BCBSNC will post this update to the employer services section of www.bcbsnc.com.

BCBSNC Women's Preventive Health Overview

On August 1, 2011, the Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) issued detailed guidelines for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA). The guidelines specifically address preventive health services that must be offered to women at no additional cost.
These guidelines are effective for all non-grandfathered group health plans (underwritten and ASO) upon the group’s effective date/renewal on or after August 1, 2012
They are also effective for:
  • new, non-grandfathered individual health plans with effective dates of August 1, 2012 or later
  • existing, non-grandfathered individual plans, with effective dates prior to August 1, 2012, on January 1, 2013
Please see the FAQs document  for more information.