PRNewswire/ -- For employees who work for companies that offer health insurance benefits through late November/early December, this is usually the time when important health plan decisions must be made for the upcoming year - 2011. Interestingly, studies show consumers typically spend more time researching car and computer purchases than they do when selecting a health insurance plan. These studies also indicate that most people spend an hour or less reviewing their insurance plan options and often default to the plan they had the previous year.
With health care reform changes in the mix, the comprehensive long-term impact is still uncertain. Nevertheless, employees must make educated and well-thought-out decisions for their 2011 benefits now, using the information that is currently available to them. Equally important, employers must do everything they can to provide their employees with the information necessary to make an informed decision. And, since open enrollment season is upon us, this is the best time to share tips to help employees navigate through the choices they must make.
Many of Georgia's companies offer more than one health insurance plan option, which typically have different costs to the employees, both in the amount deducted from their paychecks and the total cost of the coverage for deductibles, co-pays and co-insurance during the course of the year. In addition, many employers are offering base coverage plans and then offer a 'buy up' plan option where employees can purchase additional coverage not covered by the employer.
"It's a mistake not to review your health plan options each year and carefully weigh which plan will be the best fit for you and your family," said Morgan Kendrick, President, Blue Cross and Blue Shield of Georgia (BCBSGa) who noted that often consumers choose the plan that has the least impact on their paycheck when that option may not be the best choice overall.
Plans with higher monthly premiums and lower co-pays and deductibles might be best for those who anticipate using a lot of health care services throughout the course of the year. On the other hand, young and healthy employees without kids might save more with a plan that features low premiums and a high deductible.
We encourage employers to provide their employees with the tools and resources needed to help them make informed decisions about their health care coverage. Below are a few things employers can do to make this process easier:
1. Encourage Healthy Behaviors. Research shows that approximately 85 percent of ill health comes from poor health choices. Therefore, open enrollment provides a great opportunity for the promotion of health and wellness programs and incentives, including smoking cessation or weight management courses, gym subsidies, etc. Not only will this help contain company costs long-term, it also helps employees feel and perform better.
2. Hold open enrollment meetings. If possible, make them mandatory, but make them fun and interactive. Bring in an account manager from your insurance carrier or have an onsite benefits manager/HR representative explain the various health care options and answer questions on-the-spot.
3. Avoid acronyms when communicating with employees. Use simple terms and definitions, and communicate early and often. An Institute of Medicine report showed that nearly half of all U.S. adults have difficulty understanding healthcare benefits information. As a result, the materials go unread and plan selections are made haphazardly.
4. Help Familiarize Employees with Consumer-Driven Health Plans (CDHPs). CDHPs continue to gain popularity because they help employers and employees control health care costs. CDHPs provide you with health account options to help you pay for the costs of health care such as Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs). Companies that are the most successful in introducing and migrating to CDHPs take time to explain these plans to employees up front, which usually results in higher adoption rates.
Here are some items employees should keep in mind when choosing a health insurance plan:
1. Do your homework and take advantage of the tools offered to you. If your company holds open enrollment meetings, attend at least one and be prepared with questions. Take the information home and review the details in a more relaxed environment. Make sure to follow up with your company benefits advisor if you have additional questions – that's what the benefits advisor is there for.
2. Understand and learn what basic health insurance terms mean. Use online tools provided by your current health plan or other tools such as www.wikipedia.org as a reference. For example, make sure you can answer the following:
-What is the difference between co-payment and co-insurance?
-What does deductible mean and how could it impact your out-of-pocket costs?
-What does it mean to seek "out-of-network" services?
3. Examine your family's past health care spending. An excellent way to determine a good plan fit for 2010 is to understand what health care services your family used in 2010 and take into consideration what expenses may occur in the coming year—like having a child or if you will have to deal with a chronic health condition like diabetes.
4. Before continuing on your current plan, read the details. What you signed up for last year may have changed. Have the co-pays and deductibles increased? Often employers will adjust these levels as a result of the increasing cost of health care services. Pay attention to the details in order to avoid surprises down the line.
5. Verify in advance that your physician and hospital are part of the network for the plan you are choosing. This is especially important if the insurance company is changing or if you are switching to a different health plan.
6. Take advantage of your HSA, HRA or Flexible Spending Account (FSA) if appropriate. Make sure you understand the difference between an HSA, HIA, HRA and an FSA, as well as any changes in access to these funds, for example, FSA accounts have new prescription requirements surrounding over-the-counter medications.
"In the past, consumers may have quickly looked over their benefit options and made a selection without seriously considering the comprehensive financial impact it could have on them and their family," said Kendrick. "But this year, with the additional economic pressures consumers are facing and new health care reform mandates, it makes sense to really study all plan options in order to make the best choice to meet their needs."
-----
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Showing posts with label benefits. Show all posts
Showing posts with label benefits. Show all posts
Wednesday, November 17, 2010
Monday, November 15, 2010
Open Enrollment for 2011 Medicare prescription drug and health plans begins Nov. 15th
The Centers for Medicare & Medicaid Services (CMS) is encouraging all Medicare beneficiaries to take advantage of the annual Open Enrollment period to make sure they have the best coverage available to meet their health care needs in 2011.
The Medicare Open Enrollment Period this year begins on November 15th and runs through December 31st. During the Open Enrollment period, current or newly eligible Medicare beneficiaries, including people with Original Medicare, can review current health and prescription drug coverage, compare health and drug plan options available in their area, and choose coverage that best meet their needs.
"The Affordable Care Act will make Medicare stronger and more sustainable. There will be new benefits available to nearly every person with Medicare starting in January 2011, including free annual wellness visits and free recommended preventive services like mammograms and colonoscopies. Seniors who fall into the donut hole in 2011 will be eligible for a 50 percent discount on brand-name prescription drugs. These new benefits make this year's Medicare Open Enrollment Period especially important," said HHS Secretary Kathleen Sebelius. "Every year, the Medicare Open Enrollment Period gives Medicare beneficiaries a chance to evaluate their current plans and see what other options might be out there that serve their needs, especially if their health status has changed. Those enrolled in Medicare can think of the Open Enrollment Period as a yearly coverage "check-up." It is important for people with Medicare to look closely at their plan, look at the options available to them, consider their health status, and find what works for them."
"There's never been a better time for Medicare beneficiaries to check out their Medicare coverage," said CMS Administrator Donald Berwick, M.D. "With better plan choices available for 2011, Medicare beneficiaries can think of Open Enrollment as their yearly coverage 'check-up'."
"During Open Enrollment, AoA's national network of community-based organizations will work with seniors, individuals with disabilities and their caregivers across the country to help them understand the new benefits available under the Affordable Care
Act," said Kathy Greenlee, Assistant Secretary for Aging. "In addition, we urge seniors to protect themselves from potential fraud and identity theft. We know there are people who use this time to scam seniors and rip off Medicare. Seniors should protect their Medicare number the same way they do their Social Security number or credit cards."
Resources for Medicare Beneficiaries
People with Medicare, their families and other trusted representatives can review and compare current plan coverage with new plan offerings, using many proven resources, including:
. Visiting www.medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder and Medicare Options Compare tools have been enhanced for an efficient review of plan choices. Multilingual Open Enrollment information and counseling is available.
. Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
. Reviewing the 2011 Medicare &You handbook. It is also accessible at www.medicare gov and has been mailed to the homes of people with Medicare benefits.
. Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:
o At http://www.medicare.gov/contacts/organization-search-criteria.aspx or
o On the back of the 2011 Medicare &You handbook or;
o By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
o Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp
Medicare beneficiaries who cannot meet the costs of prescription drugs may be eligible for additional resources. Based on eligibility for "extra help," some people Medicare will pay no more than $2.50 for each generic drug and no more than $6.30 for each name brand drug. The program, called Medicare's Limited Income Newly Eligible Transition (NET) Program, can also help pay for premiums and other out-of-pocket costs.
There is no cost to apply for this extra help. Medicare beneficiaries, family members, trusted counselors or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) to find out more.
Protecting Against Fraud and Identity Theft
The new health care law also provides better tools to help fight waste, fraud and abuse to help protect Medicare. CMS offers tips to help beneficiaries protect themselves against fraud and identity theft during the Open Enrollment period. Medicare recommends thatpeople treat their Medicare number as they do their social security number and credit card information.
Beneficiaries should not give personal information to anyone arriving to their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048). More information is available at www.stopmedicarefraud.gov.
More information is available at www.healthcare.gov, a new web portal from the U.S. Department of Health and Human Services.
-----
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The Medicare Open Enrollment Period this year begins on November 15th and runs through December 31st. During the Open Enrollment period, current or newly eligible Medicare beneficiaries, including people with Original Medicare, can review current health and prescription drug coverage, compare health and drug plan options available in their area, and choose coverage that best meet their needs.
"The Affordable Care Act will make Medicare stronger and more sustainable. There will be new benefits available to nearly every person with Medicare starting in January 2011, including free annual wellness visits and free recommended preventive services like mammograms and colonoscopies. Seniors who fall into the donut hole in 2011 will be eligible for a 50 percent discount on brand-name prescription drugs. These new benefits make this year's Medicare Open Enrollment Period especially important," said HHS Secretary Kathleen Sebelius. "Every year, the Medicare Open Enrollment Period gives Medicare beneficiaries a chance to evaluate their current plans and see what other options might be out there that serve their needs, especially if their health status has changed. Those enrolled in Medicare can think of the Open Enrollment Period as a yearly coverage "check-up." It is important for people with Medicare to look closely at their plan, look at the options available to them, consider their health status, and find what works for them."
"There's never been a better time for Medicare beneficiaries to check out their Medicare coverage," said CMS Administrator Donald Berwick, M.D. "With better plan choices available for 2011, Medicare beneficiaries can think of Open Enrollment as their yearly coverage 'check-up'."
"During Open Enrollment, AoA's national network of community-based organizations will work with seniors, individuals with disabilities and their caregivers across the country to help them understand the new benefits available under the Affordable Care
Act," said Kathy Greenlee, Assistant Secretary for Aging. "In addition, we urge seniors to protect themselves from potential fraud and identity theft. We know there are people who use this time to scam seniors and rip off Medicare. Seniors should protect their Medicare number the same way they do their Social Security number or credit cards."
Resources for Medicare Beneficiaries
People with Medicare, their families and other trusted representatives can review and compare current plan coverage with new plan offerings, using many proven resources, including:
. Visiting www.medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder and Medicare Options Compare tools have been enhanced for an efficient review of plan choices. Multilingual Open Enrollment information and counseling is available.
. Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
. Reviewing the 2011 Medicare &You handbook. It is also accessible at www.medicare gov and has been mailed to the homes of people with Medicare benefits.
. Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:
o At http://www.medicare.gov/contacts/organization-search-criteria.aspx or
o On the back of the 2011 Medicare &You handbook or;
o By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
o Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp
Medicare beneficiaries who cannot meet the costs of prescription drugs may be eligible for additional resources. Based on eligibility for "extra help," some people Medicare will pay no more than $2.50 for each generic drug and no more than $6.30 for each name brand drug. The program, called Medicare's Limited Income Newly Eligible Transition (NET) Program, can also help pay for premiums and other out-of-pocket costs.
There is no cost to apply for this extra help. Medicare beneficiaries, family members, trusted counselors or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) to find out more.
Protecting Against Fraud and Identity Theft
The new health care law also provides better tools to help fight waste, fraud and abuse to help protect Medicare. CMS offers tips to help beneficiaries protect themselves against fraud and identity theft during the Open Enrollment period. Medicare recommends thatpeople treat their Medicare number as they do their social security number and credit card information.
Beneficiaries should not give personal information to anyone arriving to their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048). More information is available at www.stopmedicarefraud.gov.
More information is available at www.healthcare.gov, a new web portal from the U.S. Department of Health and Human Services.
-----
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Friday, October 29, 2010
Open Enrollment Goes Virtual: Blue Cross and Blue Shield of Georgia Launches Virtual Open Enrollment Center, Allowing Companies to More Easily Engage Employees
/PRNewswire/ -- For medium and large organizations, providing employees with complete, comprehensive and consistent information during open enrollment can be challenging. To help businesses reach and engage their employees more easily, Blue Cross and Blue Shield of Georgia (BCBSGA) has launched a Virtual Open Enrollment center, an easy to use, easy to understand interactive 3-D environment, which can be found at: http://tinyurl.com/23hkhqg.
"The virtual enrollment center is another way that Blue Cross and Blue Shield of Georgia is delivering the best value to our customers and the members we serve," said Morgan Kendrick, President, BCBSGA. "Many businesses tell us they want to improve their systems to more effectively and efficiently communicate important benefit information to their employees. The BCBSGA virtual open enrollment center, designed with input from businesses, was created to meet this need. Ultimately, we believe this will help individuals make the best benefit choices to fit their unique circumstances."
With the virtual enrollment center, employees can access benefits information at their convenience in a single intuitive and interactive location. Upon entering the site, a user will see a 3-D design with their company's logo and a video spokesperson delivering personalized messages. The center has scrolling marquees providing up to date messaging. The user can easily find enrollment information through simple key word searches. In addition, the virtual enrollment center has a content library, housing enrollment materials, documents that can be downloaded, and web links to additional information such as health plan details, provider lists, prescription information and other available health programs.
This is also a valuable resource for human resource departments as they can easily maintain and publish content. The virtual enrollment center gives them the ability to efficiently reach all employees, increase visibility within the organization, track the number of visitors and monitor the usage.
"BCBSGA's virtual open enrollment center has been a great resource for our business and our employees," said Hazel Davis, manager, health and welfare plans for Albemarle Corporation. "We began using this new system last week and already our employee engagement has increased, and the employee feedback has been overwhelmingly positive. Our employees are able to access the center at their convenience, helping them to more effectively select the best benefits for themselves and their families. We have been looking for a way to increase employee engagement and Blue Cross and Blue Shield of Georgia's virtual open enrollment center has been a perfect solution."
-----
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"The virtual enrollment center is another way that Blue Cross and Blue Shield of Georgia is delivering the best value to our customers and the members we serve," said Morgan Kendrick, President, BCBSGA. "Many businesses tell us they want to improve their systems to more effectively and efficiently communicate important benefit information to their employees. The BCBSGA virtual open enrollment center, designed with input from businesses, was created to meet this need. Ultimately, we believe this will help individuals make the best benefit choices to fit their unique circumstances."
With the virtual enrollment center, employees can access benefits information at their convenience in a single intuitive and interactive location. Upon entering the site, a user will see a 3-D design with their company's logo and a video spokesperson delivering personalized messages. The center has scrolling marquees providing up to date messaging. The user can easily find enrollment information through simple key word searches. In addition, the virtual enrollment center has a content library, housing enrollment materials, documents that can be downloaded, and web links to additional information such as health plan details, provider lists, prescription information and other available health programs.
This is also a valuable resource for human resource departments as they can easily maintain and publish content. The virtual enrollment center gives them the ability to efficiently reach all employees, increase visibility within the organization, track the number of visitors and monitor the usage.
"BCBSGA's virtual open enrollment center has been a great resource for our business and our employees," said Hazel Davis, manager, health and welfare plans for Albemarle Corporation. "We began using this new system last week and already our employee engagement has increased, and the employee feedback has been overwhelmingly positive. Our employees are able to access the center at their convenience, helping them to more effectively select the best benefits for themselves and their families. We have been looking for a way to increase employee engagement and Blue Cross and Blue Shield of Georgia's virtual open enrollment center has been a perfect solution."
-----
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Thursday, October 28, 2010
HHS announces nearly 700 additional employers and unions to receive help providing health coverage to early retirees and their families
Nearly 3,600 employers and unions approved to participate in the Affordable Care Act's Early Retiree Reinsurance Program to date; applications still being accepted
The U.S. Department of Health and Human Services (HHS) today released a list of additional employers and unions accepted into the Affordable Care Act's Early Retiree Reinsurance Program. Nearly 700 additional large and small businesses, state and local governments, educational institutions, non-profit organizations, and unions have been accepted into the program, which reimburses employers for a portion of the cost of health benefits for early retirees' and their families. Today's announcement brings the total number of organizations participating in the program to nearly 3,600.
"By helping employers and unions continue to offer coverage for early retirees, we're helping them compete -- while providing a measure of certainty and security for their former workers at a time when it could not be more important," said Secretary Kathleen Sebelius. "The Early Retiree Reinsurance Program seeks to shore up the financial foothold for employers and unions who want to provide coverage to their retirees."
Created by the Affordable Care Act as another bridge to the new health insurance exchanges in 2014, the Early Retiree Reinsurance Program provides $5 billion in financial assistance to employers and unions, to help them maintain coverage for early retirees ages 55 and older who are not yet eligible for Medicare. Businesses and other employers and unions that are accepted into the program will receive reimbursement for a portion of the costs of health benefits for their early retirees and their spouses, surviving spouses, and dependents. Savings may be used to reduce employer or union health care costs, provide premium or out-of-pocket relief to workers, retirees, and their families, or both. The program ends on January 1, 2014, when the state-based health insurance exchanges will be up and running.
HHS' Office of Consumer Information and Insurance Oversight has approved nearly 3,600 employer and union plans, representing a broad range of employers and unions from all 50 states and the District of Columbia, for participation in the Early Retiree Reinsurance Program, with more applications being reviewed every day. HHS has set up a website, www.ERRP.gov, where sponsors can begin submitting information today to qualify early retirees, spouses, surviving spouses, and dependents for claims reimbursements.
Employers and unions interested in the Early Retiree Reinsurance Program should visit www.ERRP.gov or call 1-877-574-3777 or 877-574-ERRP. Employers and unions can find the application form and application instructions, as well as other relevant guidance and regulations from HHS, online.
More information about the Early Retiree Reinsurance Program, a full alphabetical list of participants, and an interactive map displaying participants by state is available online. This list is updated regularly. To find this information, please visit:
http://www.healthcare.gov/news/factsheets/early_retiree_reinsurance_program.html.
-----
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The U.S. Department of Health and Human Services (HHS) today released a list of additional employers and unions accepted into the Affordable Care Act's Early Retiree Reinsurance Program. Nearly 700 additional large and small businesses, state and local governments, educational institutions, non-profit organizations, and unions have been accepted into the program, which reimburses employers for a portion of the cost of health benefits for early retirees' and their families. Today's announcement brings the total number of organizations participating in the program to nearly 3,600.
"By helping employers and unions continue to offer coverage for early retirees, we're helping them compete -- while providing a measure of certainty and security for their former workers at a time when it could not be more important," said Secretary Kathleen Sebelius. "The Early Retiree Reinsurance Program seeks to shore up the financial foothold for employers and unions who want to provide coverage to their retirees."
Created by the Affordable Care Act as another bridge to the new health insurance exchanges in 2014, the Early Retiree Reinsurance Program provides $5 billion in financial assistance to employers and unions, to help them maintain coverage for early retirees ages 55 and older who are not yet eligible for Medicare. Businesses and other employers and unions that are accepted into the program will receive reimbursement for a portion of the costs of health benefits for their early retirees and their spouses, surviving spouses, and dependents. Savings may be used to reduce employer or union health care costs, provide premium or out-of-pocket relief to workers, retirees, and their families, or both. The program ends on January 1, 2014, when the state-based health insurance exchanges will be up and running.
HHS' Office of Consumer Information and Insurance Oversight has approved nearly 3,600 employer and union plans, representing a broad range of employers and unions from all 50 states and the District of Columbia, for participation in the Early Retiree Reinsurance Program, with more applications being reviewed every day. HHS has set up a website, www.ERRP.gov, where sponsors can begin submitting information today to qualify early retirees, spouses, surviving spouses, and dependents for claims reimbursements.
Employers and unions interested in the Early Retiree Reinsurance Program should visit www.ERRP.gov or call 1-877-574-3777 or 877-574-ERRP. Employers and unions can find the application form and application instructions, as well as other relevant guidance and regulations from HHS, online.
More information about the Early Retiree Reinsurance Program, a full alphabetical list of participants, and an interactive map displaying participants by state is available online. This list is updated regularly. To find this information, please visit:
http://www.healthcare.gov/news/factsheets/early_retiree_reinsurance_program.html.
-----
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Saturday, October 02, 2010
Care Improvement Plus Releases 2011 Medicare Health Plan Benefits for Georgia
/PRNewswire/ -- Care Improvement Plus, operator of the largest special needs plan in Georgia, is standing by its commitment to serve chronically ill and underserved Medicare beneficiaries with the release of its 2011 Medicare health plan benefits in preparation for the upcoming Medicare annual election period, which begins November 15th.
"At a time when there is concern over unpredictable change in healthcare, Care Improvement Plus remains committed to our members and the underserved Medicare beneficiaries of Georgia," said Frederick C. Dunlap, chairman and chief executive officer of XLHealth, which owns and operates Care Improvement Plus. "For 2011, we are continuing to build upon our innovative model of care, providing specialized services that go well beyond what Original Medicare and most Medicare Advantage plans offer -- improving quality of care and controlling healthcare costs."
The details of Care Improvement Plus' 2011 Medicare health plan benefits include stable plan premiums with $0 options, and the continuation of valuable additional benefits and services, such as:
* Vision, dental, transportation, and Over-The-Counter benefits
* Care management program including nurse coaching and a 24-7 nurse hotline
* Free annual in-home health assessments with a licensed practitioner
* Personalized counseling sessions with plan pharmacists
* Assistance with accessing social support services
* An open access provider network with no referral required for Medicare-covered services
* $0 copays for important preventive care services
Beneficiaries with chronic conditions such as diabetes and heart failure complex healthcare needs requiring a patient-centered focus, making Care Improvement Plus an important option for more than 1,218,887 eligible Georgians to consider.
"During a time when some Medicare Advantage companies are either discontinuing or reducing their coverage, we will continue to serve Georgia Medicare beneficiaries with stability in cost and benefits," continues Dunlap.
Care Improvement Plus will open enrollment on November 15, 2010 for services effective January 1, 2011. Those interested in learning more about Care Improvement Plus may call 1-800-711-1656, or visit www.careimprovementplus.com for more information.
-----
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"At a time when there is concern over unpredictable change in healthcare, Care Improvement Plus remains committed to our members and the underserved Medicare beneficiaries of Georgia," said Frederick C. Dunlap, chairman and chief executive officer of XLHealth, which owns and operates Care Improvement Plus. "For 2011, we are continuing to build upon our innovative model of care, providing specialized services that go well beyond what Original Medicare and most Medicare Advantage plans offer -- improving quality of care and controlling healthcare costs."
The details of Care Improvement Plus' 2011 Medicare health plan benefits include stable plan premiums with $0 options, and the continuation of valuable additional benefits and services, such as:
* Vision, dental, transportation, and Over-The-Counter benefits
* Care management program including nurse coaching and a 24-7 nurse hotline
* Free annual in-home health assessments with a licensed practitioner
* Personalized counseling sessions with plan pharmacists
* Assistance with accessing social support services
* An open access provider network with no referral required for Medicare-covered services
* $0 copays for important preventive care services
Beneficiaries with chronic conditions such as diabetes and heart failure complex healthcare needs requiring a patient-centered focus, making Care Improvement Plus an important option for more than 1,218,887 eligible Georgians to consider.
"During a time when some Medicare Advantage companies are either discontinuing or reducing their coverage, we will continue to serve Georgia Medicare beneficiaries with stability in cost and benefits," continues Dunlap.
Care Improvement Plus will open enrollment on November 15, 2010 for services effective January 1, 2011. Those interested in learning more about Care Improvement Plus may call 1-800-711-1656, or visit www.careimprovementplus.com for more information.
-----
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Thursday, August 05, 2010
How Local Governments Are Addressing Retiree Health Care Funding
/PRNewswire/ -- A new issue brief from the Center for State and Local Government Excellence finds that the economy has slowed the ability of local governments to address long-term funding of their retiree health care obligations.
The brief follows up on a 2009 survey in which 206 local governments indicated they were likely to adopt a long-term strategy to strengthen their retiree health care funding, including:
-- establishing a Section 115 trust (governmental); medical subaccount
[401(h)]; or Voluntary Employee Beneficiary Association (VEBA) trust
[501(c)(9)];
-- issuing OPEB bonds;
-- increasing the years of service for vesting for RHC;
-- increasing the age at which RHC is available;
-- terminating retiree health care for all new hires.
Since then, the economy, insufficient revenues, and competing budget priorities have posed the greatest impediment to their plans.
The new brief finds that many jurisdictions are making sweeping changes in their retiree health care plans:
-- 36 percent have increased or plan to increase the years of service
required to vest.
-- 11 percent have increased the retirement age.
-- 39 percent have eliminated or plan to eliminate retiree health
benefits for new hires.
-----
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The brief follows up on a 2009 survey in which 206 local governments indicated they were likely to adopt a long-term strategy to strengthen their retiree health care funding, including:
-- establishing a Section 115 trust (governmental); medical subaccount
[401(h)]; or Voluntary Employee Beneficiary Association (VEBA) trust
[501(c)(9)];
-- issuing OPEB bonds;
-- increasing the years of service for vesting for RHC;
-- increasing the age at which RHC is available;
-- terminating retiree health care for all new hires.
Since then, the economy, insufficient revenues, and competing budget priorities have posed the greatest impediment to their plans.
The new brief finds that many jurisdictions are making sweeping changes in their retiree health care plans:
-- 36 percent have increased or plan to increase the years of service
required to vest.
-- 11 percent have increased the retirement age.
-- 39 percent have eliminated or plan to eliminate retiree health
benefits for new hires.
-----
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Monday, July 05, 2010
Statement from Secretary Sebelius on Proposed CMS Rule to Expand Medicare Preventive Services and Expand Access to Primary Care
On June 25, the Centers for Medicare & Medicaid Services (CMS) took another important step to help improve the health status of Medicare beneficiaries. The proposed regulation will implement the new preventive health benefits created under the Affordable Care Act for the seniors and persons with disabilities who rely on Medicare for their health care coverage.
The new rule proposes to make two significant improvements to preventive care benefits under Medicare: Beginning January 1, 2011, Medicare will cover annual wellness visits so that doctors and patients can develop a personalized prevention plan that takes a comprehensive approach to improving the patient’s health. Also beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services – including that annual wellness visit.
To help make sure that Medicare beneficiaries have access to primary care doctors, the rule would also boost payments for primary care services. The proposed regulation would also increase access to services by creating payment incentives for general surgeons as well as expand access to other types of health care providers.
Improving access to preventive services and primary care is a top priority for HHS. The proposed rule is just one part of a broader effort we are making to improve the health status of Medicare beneficiaries – and all Americans. We recently announced the allocation of $500 million from the Prevention and Public Health Fund – created by the Affordable Care Act – to invest in the training and development of primary care professionals as well as preventive care activities and public health infrastructure.
With these new benefits under Medicare, and investments in our health care system, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease.
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The new rule proposes to make two significant improvements to preventive care benefits under Medicare: Beginning January 1, 2011, Medicare will cover annual wellness visits so that doctors and patients can develop a personalized prevention plan that takes a comprehensive approach to improving the patient’s health. Also beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services – including that annual wellness visit.
To help make sure that Medicare beneficiaries have access to primary care doctors, the rule would also boost payments for primary care services. The proposed regulation would also increase access to services by creating payment incentives for general surgeons as well as expand access to other types of health care providers.
Improving access to preventive services and primary care is a top priority for HHS. The proposed rule is just one part of a broader effort we are making to improve the health status of Medicare beneficiaries – and all Americans. We recently announced the allocation of $500 million from the Prevention and Public Health Fund – created by the Affordable Care Act – to invest in the training and development of primary care professionals as well as preventive care activities and public health infrastructure.
With these new benefits under Medicare, and investments in our health care system, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease.
-----
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Wednesday, June 02, 2010
ObamaCare: Giant Meteor Scheduled to Strike in 2014
/PRNewswire/ -- Some argue that ObamaCare isn't ripe for legal challenge, since the most onerous requirements won't be in effect until 2014. By then, the machinery for implementation, and associated "stakeholders," will be cemented in place and much harder to dislodge.
The effect, however, is already being felt, argues attorney Andrew Schlafly, writing in the summer issue of the Journal of American Physicians and Surgeons (http://www.jpands.org/vol15no2/schlafly.pdf). Schlafly is general counsel for the Association of American Physicians and Surgeons (AAPS), which filed suit in the District of Columbia on March 26, three days after the Patient Protection and Affordable Care Act (PPACA or "ObamaCare") was signed into law (www.aapsonline.org/hhslawsuit).
"By analogy," he writes, "if we knew that a giant meteor would crash into the Earth in 2014, it would have a huge immediate impact on behavior today."
After enactment of PPACA, there was a 10 percent drop in the value of health-related stocks, while the rest of the stock market was rising.
Some physicians are planning an early retirement, and bright students will forgo a medical career because they want to practice "innovative medicine in the free market rather than Post Office-style medicine controlled by government bureaucrats."
Likely physician shortages may keep businesses from relocating to rural areas, and anticipated new costs may keep businesses from expanding.
AAPS argues that it is an unconstitutional "taking" to force individuals to buy insurance they do not want, and which may not cover the medical care that they eventually do need.
Mandatory insurance has failed in Massachusetts, where there have been relatively few uninsured, and imposing that approach on a nation 50 times as large as and less wealthy than Massachusetts is likely to be a still bigger failure.
Schlafly cites a reason for cautious optimism: free enterprise could still expand "amid the rubble and ruins wrought by this legislation."
In addition to overturning the insurance mandates, the lawsuit asks the Court to demand an honest accounting of the solvency of the Medicare and Social Security programs, and to invalidate a rule that seniors must forfeit all Social Security benefits if they decline to participate in Medicare Part A, with its increasingly draconian restrictions.
-----
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The effect, however, is already being felt, argues attorney Andrew Schlafly, writing in the summer issue of the Journal of American Physicians and Surgeons (http://www.jpands.org/vol15no2/schlafly.pdf). Schlafly is general counsel for the Association of American Physicians and Surgeons (AAPS), which filed suit in the District of Columbia on March 26, three days after the Patient Protection and Affordable Care Act (PPACA or "ObamaCare") was signed into law (www.aapsonline.org/hhslawsuit).
"By analogy," he writes, "if we knew that a giant meteor would crash into the Earth in 2014, it would have a huge immediate impact on behavior today."
After enactment of PPACA, there was a 10 percent drop in the value of health-related stocks, while the rest of the stock market was rising.
Some physicians are planning an early retirement, and bright students will forgo a medical career because they want to practice "innovative medicine in the free market rather than Post Office-style medicine controlled by government bureaucrats."
Likely physician shortages may keep businesses from relocating to rural areas, and anticipated new costs may keep businesses from expanding.
AAPS argues that it is an unconstitutional "taking" to force individuals to buy insurance they do not want, and which may not cover the medical care that they eventually do need.
Mandatory insurance has failed in Massachusetts, where there have been relatively few uninsured, and imposing that approach on a nation 50 times as large as and less wealthy than Massachusetts is likely to be a still bigger failure.
Schlafly cites a reason for cautious optimism: free enterprise could still expand "amid the rubble and ruins wrought by this legislation."
In addition to overturning the insurance mandates, the lawsuit asks the Court to demand an honest accounting of the solvency of the Medicare and Social Security programs, and to invalidate a rule that seniors must forfeit all Social Security benefits if they decline to participate in Medicare Part A, with its increasingly draconian restrictions.
-----
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Wednesday, May 26, 2010
WellPoint Announces It Will Unilaterally Implement Key Provisions of the 'Breast Cancer Patient Protection Act'
/PRNewswire/ -- WellPoint, Inc. (NYSE:WLP) , the nation's largest health insurer by medical membership, announced today it will unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced by U.S. Representative Rosa DeLauro. These new provisions include more transparent benefit language including clear explanations of benefits to members with breast cancer, and the provisions standardize minimum recovery times in the hospital for women recovering from mastectomy.
The adoption of these provisions builds on WellPoint's existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of WellPoint's members already receive the standard of care indicated in the legislation. However, WellPoint believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, WellPoint will standardize clinical guidelines for women recovering from mastectomy to offer a voluntary 48-hour minimum in-hospital stay.
"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Sam Nussbaum, Chief Medical Officer, WellPoint. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that WellPoint continues to lead in this area," he added.
"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments to shape improvements in care for women with breast cancer," said Nussbaum. "Our goal is to ensure that our members receive optimal care."
WellPoint also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, WellPoint is taking steps to provide comprehensible, straight-forward explanations of benefits so that members more clearly understand their treatment options.
"WellPoint works to ensure that all of our members are getting best practice care," said Dijuana Lewis, Chief Executive Officer of WellPoint's Comprehensive Health Solutions business unit. "We are especially proud of our record in improving care for women with breast cancer in this country and believe these added measures will increase the quality of care that our members receive."
-----
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The adoption of these provisions builds on WellPoint's existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of WellPoint's members already receive the standard of care indicated in the legislation. However, WellPoint believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, WellPoint will standardize clinical guidelines for women recovering from mastectomy to offer a voluntary 48-hour minimum in-hospital stay.
"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Sam Nussbaum, Chief Medical Officer, WellPoint. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that WellPoint continues to lead in this area," he added.
"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments to shape improvements in care for women with breast cancer," said Nussbaum. "Our goal is to ensure that our members receive optimal care."
WellPoint also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, WellPoint is taking steps to provide comprehensible, straight-forward explanations of benefits so that members more clearly understand their treatment options.
"WellPoint works to ensure that all of our members are getting best practice care," said Dijuana Lewis, Chief Executive Officer of WellPoint's Comprehensive Health Solutions business unit. "We are especially proud of our record in improving care for women with breast cancer in this country and believe these added measures will increase the quality of care that our members receive."
-----
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Thursday, December 03, 2009
Sebelius Statement on Benefits of Health Insurance Reform for Businesses
HHS Secretary Kathleen Sebelius today highlighted the benefits of health insurance reform for businesses and released a new fact sheet regarding a recent analysis from the Congressional Budget Office.
"Businesses across the country are struggling under the weight of high health care costs," Secretary Sebelius said. "Health insurance reform will help lift this burden, help businesses prosper, and ensure workers have the affordable, quality health care they need."
A fact sheet regarding the analysis is included below.
Fact Sheet: New CBO Analysis Confirms Benefits of Health Insurance Reform for Businesses
American businesses know the health care status quo is unacceptable. Since 2000, premiums have more than doubled, a rate three times faster than the growth in wages. Between 2000 and 2009, the percentage of firms offering coverage fell from 69 to 60, with much of that drop occurring in the past year alone. Small businesses in particular struggle under the current health care system. For firms employing less than 10 workers, the erosion in coverage is striking -- from 57 percent offering coverage in 2000 to 46 percent offering coverage in 2009. If we do nothing, over the next ten years, health care costs for large businesses are projected to reach $28,530 per employee, a 116 percent increase from 2009.
A new analysis by the Congressional Budget Office (CBO) affirms that businesses' health insurance costs will be lower under health insurance reform -- even though the analysis does not take into account the full range of policies that will benefit businesses.
Health Insurance Premiums for Businesses According to CBO. In a November 30 letter to Senator Evan Bayh, CBO assesses the impact of the Patient Protection and Affordability Act on premiums for the individual, small-group, and large group markets. In 2016, CBO estimates that 159 million or 83 percent of privately insured people will be insured through employers.
Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:
-- Lower administrative overhead. Right now, each small business
has to consult with a broker or hire someone to collate plan
information, assist employees with decisions, and handle issues as they
arise. Under reform, in the exchange, there will be people whose job it
is to provide plan information and facilitate enrollment. The exchange
centralizes what is otherwise a process that is extremely duplicative,
streamlining administrative costs and lowering premiums.
-- Greater competition. CBO attributes savings to "providing a
centralized marketplace in which consumers could compare the premiums of
relatively standardized insurance products." This includes competitive
pressure from a public health insurance option.
-- Administrative simplification. Physicians spend on average about
140 hours and $68,000 a year just dealing with health insurance
bureaucracy. By simplifying and standardizing paperwork and
computerizing medical records, doctors will be able to focus on caring
for their patients instead of dealing with bureaucracy. CBO estimates
nearly $20 billion in Federal savings over 10 years, with additional
savings accruing to businesses and families.
Up to 3 percent premium savings as the risk pool for employer-based coverage improves. Today, businesses have seen their premiums skyrocket every year, with many facing double digit percentage increases in their premiums. Health insurance reform will stop this trend.
With nearly 30 million additional Americans gaining health insurance, the purchasing pool for businesses will expand and, largely, improve. Big businesses will save from 0 to 3 percent on premiums due to the changing risk pool while small businesses could save 1 percent on
premiums.
Better options for small businesses. Small businesses would gain access to the health insurance exchanges and new benefit options and tax credits under reform.
-- 3.6 million small businesses could qualify for a tax credit to
help pay their premiums.[vii] An estimated 12 percent of people insured
through small businesses will qualify for tax credits that lower
premiums by 8 to 11 percent. This translates into $620 to $860 for
individuals and $1,540 to $2,120 for families assuming that the coverage
is comparable to what they get today.
-- Today, small businesses often have coverage that has high
deductibles and gap-ridden benefits. The legislation offers such
businesses better options that CBO assumes businesses will take. Such
better coverage has premiums that are 0 to 3 percent higher than the
average plans today, but will save money for employees by ensuring they
are not forced to pay high out-of-pocket costs for services not covered
by their current insurance.
-- In the current health insurance system, small businesses may see
premiums skyrocket if just one or two workers fall ill and accumulate
high medical costs. Health insurance reform will prevent insurance
discrimination based on health status, meaning that small businesses
will no longer be unfairly penalized if a worker falls ill.
9 to 12 percent premium savings for high-premium plans under current law. By assessing high-cost plans, the excise tax encourages businesses and individuals to streamline coverage, leading to lower premiums over time.
-- CBO estimates that the 19 percent of people in employer-coverage
in high-cost plans today will pay 9 to 12 percent less under reform.
This translates to premium savings of at least $835 for single and
$2,070 family policies.
-- This could yield increases in workers wages, by around $70
billion in 2019.
Nearly $10 billion in savings for small businesses.
-- Under current law, CBO estimates premiums to be $7,800 for
single policies and $19,300 for families in the small group market.
-- Small businesses that opt for comparable coverage under reform
could save up to $390 for single policies and $965 for family policies.
Assuming all 25 million people insured through small business save at
least $390 (more for families), this will yield nearly $10 billion in
savings in 2016 alone.
-- Additional savings will accrue to low-wage, small businesses
that newly offer coverage in the exchange. CBO estimates that roughly
12 percent of people in the small group market would get the credit
which would reduce premiums by about 10 percent in 2016. Multiplying
this by the population and average premiums in the report, this suggests
that about one and a half million people would save roughly $780 per
person on premiums in 2016.
-- Even those that CBO estimates will "buy-up" will save, paying
$100 less per family for coverage that is more protective.
At least $13.4 billion in savings for large businesses.
-- Under current law, CBO estimates premiums to be $7,400 for
single policies and $20,300 for families in the large group market.
-- CBO estimates that, under reform, large business premiums will
drop by $100 per single policy and $200 per family policy. With 134
million people enrolled in such coverage, this translates into at least
$13.4 billion in savings in 2016 alone.
Businesses can keep what they have.
-- CBO affirms that any proposed benefit mandates would not affect
the small or large group markets: "The requirement would have relatively
little effect on premiums in the small group market, however, because
most policies sold in that market already cover those services and would
continue to cover them under current law."
-- CBO also affirms the effectiveness of the grandfather policy:
"Further, small group policies that are maintained continuously would be
grandfathered under the proposal."
-- In the large group market, CBO affirms that "[Benefit]
requirements would have no significant effect on premiums in the large
group market."
No cost-shifting to the employer-based insurance market.
-- CBO states: "... CBO's assessment is that the legislation would
have minimal effects on private-sector premiums via cost shifting."
Additional Policies To Benefit Businesses. CBO does not include in its analysis several additional policies in the Patient Protection and Affordable Care Act that would benefit businesses.
Reinsurance for businesses that cover early retiree plans.
-- The proportion of employers that offer retiree coverage has been
declining precipitously over time, from 66 percent in 1988 to 29 percent
in 2009.
-- The proposal would provide a time-limited, Federal reinsurance
program to cover some of the cost of covering early retirees. This
translates to savings of up to $1,200 off the premium of every family
plan offered by that company.
Policies to slow health care cost growth.
-- Insurance oversight: In recent years, several states' insurance
commissioners have rejected unjustifiably high premium increases in the
small group and individual insurance markets. Health insurance reform
will allow insurance commissioners to continue to play this important
role and require transparency and oversight of premium increases.
-- Delivery system reform. Health insurance reform will invest in
care innovations such as accountable care organizations, make healthcare
providers more accountable and efficient through value-based purchasing,
and improve quality and patient safety, including reducing preventable
readmissions. A recent report by the Business Roundtable found that if
many of the delivery system reforms were adopted by the private sector,
large businesses could save $3,000 per employee by 2019.
-- Lowers expensive drug costs. Biologic drugs are some of the most
expensive drugs on the market, and yet there is no streamlined avenue to
get generics on the market to provide lower-cost alternatives. Reform
will create an expedited process to make generic biologic drugs
available, significantly lowering drug costs.
Immediate benefits. While the CBO report provides savings estimates for 2016, several of the policies discussed above would take effect immediately, including early retiree reinsurance, administrative simplification, small business tax credits, and increased oversight of the insurance industry.
Benefits to Businesses Beyond Lower Costs. CBO focused exclusively on health insurance premiums which are critical to businesses. There would be other benefits of health reform for businesses as well.
Improved workplace productivity.
-- The Institute of Medicine found that lost productivity due to
untreated illness among uninsured workers cost businesses between $75
billion and $150 billion per year. Expanding coverage to the uninsured
will create a more productive workforce.
-- Current job-lock (inability to leave current employment if it
will result in loss of health insurance) has been demonstrated to hurt
the economy through reduced productivity, and prevents an employee from
taking a job with potentially higher wages. By ending limitations on
coverage based on pre-existing conditions and expanding portable
coverage options through the health insurance exchange, reform will
increase the flexibility and productivity of the workforce.
New jobs.
-- Bringing down the cost of healthcare will enable investments in
business and job creation. The President's Council of Economic Advisers
(CEA) estimated that if the annual growth rate of health spending slows
by 1.5 percentage point, new jobs could rise by 500,000.
-- The health insurance exchange will expand options for coverage,
making small businesses a more attractive place for people to work, and
encouraging people to start up businesses of their own.
-- Health insurance reform could save 80,000 jobs in the small
business sector by 2019 and increase take-home pay by almost $30
billion.
-----
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"Businesses across the country are struggling under the weight of high health care costs," Secretary Sebelius said. "Health insurance reform will help lift this burden, help businesses prosper, and ensure workers have the affordable, quality health care they need."
A fact sheet regarding the analysis is included below.
Fact Sheet: New CBO Analysis Confirms Benefits of Health Insurance Reform for Businesses
American businesses know the health care status quo is unacceptable. Since 2000, premiums have more than doubled, a rate three times faster than the growth in wages. Between 2000 and 2009, the percentage of firms offering coverage fell from 69 to 60, with much of that drop occurring in the past year alone. Small businesses in particular struggle under the current health care system. For firms employing less than 10 workers, the erosion in coverage is striking -- from 57 percent offering coverage in 2000 to 46 percent offering coverage in 2009. If we do nothing, over the next ten years, health care costs for large businesses are projected to reach $28,530 per employee, a 116 percent increase from 2009.
A new analysis by the Congressional Budget Office (CBO) affirms that businesses' health insurance costs will be lower under health insurance reform -- even though the analysis does not take into account the full range of policies that will benefit businesses.
Health Insurance Premiums for Businesses According to CBO. In a November 30 letter to Senator Evan Bayh, CBO assesses the impact of the Patient Protection and Affordability Act on premiums for the individual, small-group, and large group markets. In 2016, CBO estimates that 159 million or 83 percent of privately insured people will be insured through employers.
Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:
-- Lower administrative overhead. Right now, each small business
has to consult with a broker or hire someone to collate plan
information, assist employees with decisions, and handle issues as they
arise. Under reform, in the exchange, there will be people whose job it
is to provide plan information and facilitate enrollment. The exchange
centralizes what is otherwise a process that is extremely duplicative,
streamlining administrative costs and lowering premiums.
-- Greater competition. CBO attributes savings to "providing a
centralized marketplace in which consumers could compare the premiums of
relatively standardized insurance products." This includes competitive
pressure from a public health insurance option.
-- Administrative simplification. Physicians spend on average about
140 hours and $68,000 a year just dealing with health insurance
bureaucracy. By simplifying and standardizing paperwork and
computerizing medical records, doctors will be able to focus on caring
for their patients instead of dealing with bureaucracy. CBO estimates
nearly $20 billion in Federal savings over 10 years, with additional
savings accruing to businesses and families.
Up to 3 percent premium savings as the risk pool for employer-based coverage improves. Today, businesses have seen their premiums skyrocket every year, with many facing double digit percentage increases in their premiums. Health insurance reform will stop this trend.
With nearly 30 million additional Americans gaining health insurance, the purchasing pool for businesses will expand and, largely, improve. Big businesses will save from 0 to 3 percent on premiums due to the changing risk pool while small businesses could save 1 percent on
premiums.
Better options for small businesses. Small businesses would gain access to the health insurance exchanges and new benefit options and tax credits under reform.
-- 3.6 million small businesses could qualify for a tax credit to
help pay their premiums.[vii] An estimated 12 percent of people insured
through small businesses will qualify for tax credits that lower
premiums by 8 to 11 percent. This translates into $620 to $860 for
individuals and $1,540 to $2,120 for families assuming that the coverage
is comparable to what they get today.
-- Today, small businesses often have coverage that has high
deductibles and gap-ridden benefits. The legislation offers such
businesses better options that CBO assumes businesses will take. Such
better coverage has premiums that are 0 to 3 percent higher than the
average plans today, but will save money for employees by ensuring they
are not forced to pay high out-of-pocket costs for services not covered
by their current insurance.
-- In the current health insurance system, small businesses may see
premiums skyrocket if just one or two workers fall ill and accumulate
high medical costs. Health insurance reform will prevent insurance
discrimination based on health status, meaning that small businesses
will no longer be unfairly penalized if a worker falls ill.
9 to 12 percent premium savings for high-premium plans under current law. By assessing high-cost plans, the excise tax encourages businesses and individuals to streamline coverage, leading to lower premiums over time.
-- CBO estimates that the 19 percent of people in employer-coverage
in high-cost plans today will pay 9 to 12 percent less under reform.
This translates to premium savings of at least $835 for single and
$2,070 family policies.
-- This could yield increases in workers wages, by around $70
billion in 2019.
Nearly $10 billion in savings for small businesses.
-- Under current law, CBO estimates premiums to be $7,800 for
single policies and $19,300 for families in the small group market.
-- Small businesses that opt for comparable coverage under reform
could save up to $390 for single policies and $965 for family policies.
Assuming all 25 million people insured through small business save at
least $390 (more for families), this will yield nearly $10 billion in
savings in 2016 alone.
-- Additional savings will accrue to low-wage, small businesses
that newly offer coverage in the exchange. CBO estimates that roughly
12 percent of people in the small group market would get the credit
which would reduce premiums by about 10 percent in 2016. Multiplying
this by the population and average premiums in the report, this suggests
that about one and a half million people would save roughly $780 per
person on premiums in 2016.
-- Even those that CBO estimates will "buy-up" will save, paying
$100 less per family for coverage that is more protective.
At least $13.4 billion in savings for large businesses.
-- Under current law, CBO estimates premiums to be $7,400 for
single policies and $20,300 for families in the large group market.
-- CBO estimates that, under reform, large business premiums will
drop by $100 per single policy and $200 per family policy. With 134
million people enrolled in such coverage, this translates into at least
$13.4 billion in savings in 2016 alone.
Businesses can keep what they have.
-- CBO affirms that any proposed benefit mandates would not affect
the small or large group markets: "The requirement would have relatively
little effect on premiums in the small group market, however, because
most policies sold in that market already cover those services and would
continue to cover them under current law."
-- CBO also affirms the effectiveness of the grandfather policy:
"Further, small group policies that are maintained continuously would be
grandfathered under the proposal."
-- In the large group market, CBO affirms that "[Benefit]
requirements would have no significant effect on premiums in the large
group market."
No cost-shifting to the employer-based insurance market.
-- CBO states: "... CBO's assessment is that the legislation would
have minimal effects on private-sector premiums via cost shifting."
Additional Policies To Benefit Businesses. CBO does not include in its analysis several additional policies in the Patient Protection and Affordable Care Act that would benefit businesses.
Reinsurance for businesses that cover early retiree plans.
-- The proportion of employers that offer retiree coverage has been
declining precipitously over time, from 66 percent in 1988 to 29 percent
in 2009.
-- The proposal would provide a time-limited, Federal reinsurance
program to cover some of the cost of covering early retirees. This
translates to savings of up to $1,200 off the premium of every family
plan offered by that company.
Policies to slow health care cost growth.
-- Insurance oversight: In recent years, several states' insurance
commissioners have rejected unjustifiably high premium increases in the
small group and individual insurance markets. Health insurance reform
will allow insurance commissioners to continue to play this important
role and require transparency and oversight of premium increases.
-- Delivery system reform. Health insurance reform will invest in
care innovations such as accountable care organizations, make healthcare
providers more accountable and efficient through value-based purchasing,
and improve quality and patient safety, including reducing preventable
readmissions. A recent report by the Business Roundtable found that if
many of the delivery system reforms were adopted by the private sector,
large businesses could save $3,000 per employee by 2019.
-- Lowers expensive drug costs. Biologic drugs are some of the most
expensive drugs on the market, and yet there is no streamlined avenue to
get generics on the market to provide lower-cost alternatives. Reform
will create an expedited process to make generic biologic drugs
available, significantly lowering drug costs.
Immediate benefits. While the CBO report provides savings estimates for 2016, several of the policies discussed above would take effect immediately, including early retiree reinsurance, administrative simplification, small business tax credits, and increased oversight of the insurance industry.
Benefits to Businesses Beyond Lower Costs. CBO focused exclusively on health insurance premiums which are critical to businesses. There would be other benefits of health reform for businesses as well.
Improved workplace productivity.
-- The Institute of Medicine found that lost productivity due to
untreated illness among uninsured workers cost businesses between $75
billion and $150 billion per year. Expanding coverage to the uninsured
will create a more productive workforce.
-- Current job-lock (inability to leave current employment if it
will result in loss of health insurance) has been demonstrated to hurt
the economy through reduced productivity, and prevents an employee from
taking a job with potentially higher wages. By ending limitations on
coverage based on pre-existing conditions and expanding portable
coverage options through the health insurance exchange, reform will
increase the flexibility and productivity of the workforce.
New jobs.
-- Bringing down the cost of healthcare will enable investments in
business and job creation. The President's Council of Economic Advisers
(CEA) estimated that if the annual growth rate of health spending slows
by 1.5 percentage point, new jobs could rise by 500,000.
-- The health insurance exchange will expand options for coverage,
making small businesses a more attractive place for people to work, and
encouraging people to start up businesses of their own.
-- Health insurance reform could save 80,000 jobs in the small
business sector by 2019 and increase take-home pay by almost $30
billion.
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Friday, October 30, 2009
Policymakers Have Many Options to Make Social Security Both Solvent and More Adequate
/PRNewswire/ -- Social Security, the foundation of economic security for millions of America's seniors and working families, can be made more adequate and solvent for the long term, according to a new report released today by the National Academy of Social Insurance (NASI).
The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
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The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
-----
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Arts Across Georgia
Wednesday, October 21, 2009
Humana Will Cover H1N1 Vaccine for Members
(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) today announced that the company will cover the administration cost of the H1N1 (swine flu) vaccine for all fully insured members including those members who have a benefit plan that excludes immunization coverage. All co-payment, coinsurance and deductibles will be waived for the administration of the H1N1 vaccination regardless of the preventative-services benefit currently provided in these members’ plans.
“The safety and well-being of our health plan members, country, communities and associates is of utmost concern to Humana,” said Lisa Weaver, M.D., Humana segment vice president, clinical strategies. “Our initial focus is to encourage the CDC-identified priority groups to get vaccinated.”
Humana is taking this step to support its members’ ability to get the vaccination. The company will continue to monitor and respond to guidance from the Centers for Disease Control and Prevention. For the most up-to-date H1N1 information, log on to their website: www.cdc.gov/h1n1flu/. To reach the CDC by phone call 800-CDC-INFO (800-232-4636) or email: cdcinfo@cdc.gov.
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“The safety and well-being of our health plan members, country, communities and associates is of utmost concern to Humana,” said Lisa Weaver, M.D., Humana segment vice president, clinical strategies. “Our initial focus is to encourage the CDC-identified priority groups to get vaccinated.”
Humana is taking this step to support its members’ ability to get the vaccination. The company will continue to monitor and respond to guidance from the Centers for Disease Control and Prevention. For the most up-to-date H1N1 information, log on to their website: www.cdc.gov/h1n1flu/. To reach the CDC by phone call 800-CDC-INFO (800-232-4636) or email: cdcinfo@cdc.gov.
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Monday, June 01, 2009
HHS Releases $30 Million to Help Medicare Beneficiaries Access Their Benefits
HHS Secretary Kathleen Sebelius today released $25 million in grants to
help older people, individuals with disabilities and their caregivers
apply for special assistance through Medicare, and an additional $5
million for a national resource center to support these important
efforts.
These grants, made possible by the Medicare Improvements for Patients
and Providers Act of 2008 (MIPPA), will provide valuable support at the
state and community levels for organizations involved in reaching and
providing assistance to people likely to be eligible for the Low-Income
Subsidy program (LIS), Medicare Savings Program (MSP), the Medicare Part
D Prescription Drug Program and in helping beneficiaries to apply for
benefits. This initiative also includes special targeting efforts to
rural areas of the country and to Native American elders.
"Medicare is essential to our effort to provide high-quality health care
to all Americans," said Secretary Sebelius. "Many people could be
eligible for extra help through Medicare and not even know it. We know
that beneficiaries with the greatest needs are often the most difficult
to reach," said Secretary Sebelius. "Through these new collaborations at
the federal, state and local levels, we will better be able to target
and provide one-on-one assistance to our most vulnerable citizens."
This MIPPA funding, which is jointly administered by HHS' Administration
on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS),
is being awarded to State Health Insurance Assistance Programs (SHIPs),
State Agencies on Aging, Area Agencies on Aging (AAAs), Aging and
Disability Resource Centers (ADRCs), Native Americans Tribal
Organizations and local communities to help seniors, caregivers and
those with disabilities on Medicare. These organizations are important
members of HHS' national network of state, tribal and community-based
organizations that assist seniors, caregivers and those with
disabilities with health benefits information and information on other
services, and enable them to remain independent and living in their
communities as long as possible.
"HHS is working hard to reach people who are unaware, unsure or unable
to apply for assistance for the benefits they deserve," said Charlene
Frizzera, acting administrator for CMS. "Through this collaboration
between AoA and CMS, state and community-based organizations will be
able to work in partnership and make maximum use of these federal funds
to help seniors and those with disabilities on Medicare." CMS and AoA
have worked closely together on this and other outreach efforts to
assist older Americans, those with disabilities and their families to
access important benefits and services.
"MIPPA presents a new opportunity to build on the successful partnership
between AoA and CMS through the Medicare Part D outreach efforts, our
Chronic Disease Self-Management Programs, ADRCs, and the National
Clearinghouse for Long-Term Care Information," said Edwin L. Walker,
acting Assistant Secretary for Aging. "This new effort allows us to
team up again so that we can leverage federal, state and local resources
to deliver health and long-term care services and information to those
who need it most."
The National Center for Benefits Outreach and Enrollment, administered
by the National Council on Aging (NCOA), will help inform beneficiaries
about benefits available under federal and state programs, utilize
cost-effective strategies to find older individuals with the greatest
economic need, coordinate state and local efforts by providing a best
practice clearinghouse, data collection, training and technical
assistance.
-----
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help older people, individuals with disabilities and their caregivers
apply for special assistance through Medicare, and an additional $5
million for a national resource center to support these important
efforts.
These grants, made possible by the Medicare Improvements for Patients
and Providers Act of 2008 (MIPPA), will provide valuable support at the
state and community levels for organizations involved in reaching and
providing assistance to people likely to be eligible for the Low-Income
Subsidy program (LIS), Medicare Savings Program (MSP), the Medicare Part
D Prescription Drug Program and in helping beneficiaries to apply for
benefits. This initiative also includes special targeting efforts to
rural areas of the country and to Native American elders.
"Medicare is essential to our effort to provide high-quality health care
to all Americans," said Secretary Sebelius. "Many people could be
eligible for extra help through Medicare and not even know it. We know
that beneficiaries with the greatest needs are often the most difficult
to reach," said Secretary Sebelius. "Through these new collaborations at
the federal, state and local levels, we will better be able to target
and provide one-on-one assistance to our most vulnerable citizens."
This MIPPA funding, which is jointly administered by HHS' Administration
on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS),
is being awarded to State Health Insurance Assistance Programs (SHIPs),
State Agencies on Aging, Area Agencies on Aging (AAAs), Aging and
Disability Resource Centers (ADRCs), Native Americans Tribal
Organizations and local communities to help seniors, caregivers and
those with disabilities on Medicare. These organizations are important
members of HHS' national network of state, tribal and community-based
organizations that assist seniors, caregivers and those with
disabilities with health benefits information and information on other
services, and enable them to remain independent and living in their
communities as long as possible.
"HHS is working hard to reach people who are unaware, unsure or unable
to apply for assistance for the benefits they deserve," said Charlene
Frizzera, acting administrator for CMS. "Through this collaboration
between AoA and CMS, state and community-based organizations will be
able to work in partnership and make maximum use of these federal funds
to help seniors and those with disabilities on Medicare." CMS and AoA
have worked closely together on this and other outreach efforts to
assist older Americans, those with disabilities and their families to
access important benefits and services.
"MIPPA presents a new opportunity to build on the successful partnership
between AoA and CMS through the Medicare Part D outreach efforts, our
Chronic Disease Self-Management Programs, ADRCs, and the National
Clearinghouse for Long-Term Care Information," said Edwin L. Walker,
acting Assistant Secretary for Aging. "This new effort allows us to
team up again so that we can leverage federal, state and local resources
to deliver health and long-term care services and information to those
who need it most."
The National Center for Benefits Outreach and Enrollment, administered
by the National Council on Aging (NCOA), will help inform beneficiaries
about benefits available under federal and state programs, utilize
cost-effective strategies to find older individuals with the greatest
economic need, coordinate state and local efforts by providing a best
practice clearinghouse, data collection, training and technical
assistance.
-----
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