Archive for March 2012
Department of Health & Human Services Releases Bulletin on Actuarial Value and Cost-Sharing Reduction
On Friday, February 24 the Department of Health and Human Services (HHS) released a bulletin describing the proposed approach on how to value qualified health plans and other non-grandfathered coverage plans that will be offered in the small and individual markets after January 1, 2014. The HHS proposal includes:
- National Standardized approach to determine actuarial value (AV)
- Development of a national, publicly available AV calculator to score plans based on offered benefits
- Treatment of HSA/HRA in determining AV of a plan
- Cost Sharing Reductions and Out‐of‐Pocket Limits
After January 1, 2014, individual and small group plans must be sold and marketed on a “metal tier” scale based on their individual AV scores. Metal tier ranking includes platinum, gold, silver and bronze levels. This requirement under the Patient Protection and Affordable Care Act provides a side‐by‐side cost sharing comparison of benefits allowing consumers the ability to make more informed decisions regarding their benefit plans.
In addition, the bulletin addresses the treatment of Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA) in regard to calculating AV. To ensure that high-deductible health plans (HDHPs) are valued fairly, the HHS states in the bulletin “we intend to propose that for purposes of calculating the AV of an employer health benefit plan, the annual employer contribution to the employee’s HSA associated with a qualifying HDHP and the amount made available for the first time in a given year under a HRA that is liked to an employer health benefit plan shall be considered part of the benefit design of the health plan.”
Since provider reimbursement levels and utilization can vary from state to state, the HHS has also proposed that the states be give some flexibility on developing their own AV scorecard using the national AV formula as a model.
The Department of Health and Human Services (HHS) welcomes public input on the Actuarial Value and Cost‐Sharing Reduction bulletin. Comments may be sent to ActuarialValue@cms.hhs.gov or CostSharingReductions@cms.hhs.gov.
If you have any questions about your specific coverage plan, contact your insurance broker.
Neace Lukens announced that its Cleveland office was a recipient of a Wellness @ Work award, presented by the Cleveland Museum of Natural History. The award recognized Neace Lukens commitment to employee health, work/life balance, continuing education, new life experiences, the community and an improved quality of life.
To read more about the award, see the full press release here:
Guest Post by Andy Stubblefield, Personal Lines Director
Let the boating season begin! To ensure your first day back on the water is leisurely, fun and safe, you should take a few simple precautions. Here are some helpful tips to review before venturing out on the seas:
- Own a Boat? Get insured. Update your registration and purchase or renew your boat insurance. To ensure that your investment is protected, check to see if your plan covers boat injuries, theft and damage.
- Boats Need TLC, too. Do a walk-around of your boat. Check for any propeller damage, including dings, cracks, warping or misalignment. Check hoses, cables and belts to make sure they are tight and not brittle. Lubricate fittings if needed. Check the hull for chipping, peeling or blistering. Get your engine ready by changing the fuel, oil filters and the oil. Make sure your battery is charged.
- Safety First. Check your life jackets. The U.S. Coast Guard requires there be a life jacket for every person on board and it should be in good condition. Also, make sure you have a fire extinguisher and medical kit.
- Prepare for Fun. Whatever your favorite activities are while boating, make sure you have all the necessary equipment, such as fishing gear accessories or tow ropes for water skiing.
- Experience Matters. The U.S. Coast Guard says that operator errors account for 70 percent of all boating accidents. Make sure anyone who drives your boat is properly trained.
Reviewing these precautions and completing these tasks may help you have a safe and fun boating season. For more information or questions about your boating insurance, it’s advised that you contact your insurance agent.
A company’s most important resources are its employees. However, when employees experience health complications, not only are they personally affected, but the company’s well-being is impacted, too. Prioritizing employee health and wellness can help to create a more productive workforce and bolster the bottom line.
One of the most concerning health complications that many Americans face is cardiovascular disease. More than 80 million people are affected by some form of cardiovascular disease at any given time. The Centers for Disease Control and Prevention (CDC) reports that heart disease is the leading cause of death in theU.S., and stroke ranks as number three.
Cardiovascular disease also has economic implications for employers. Expenditures associated with treating cardiovascular disease, incurred health care costs, workers’ compensation payouts and sick leave pay continue to grow and deplete company resources. Employers are also affected by loss of workforce productivity due to disability or death from cardiovascular disease. As a result, taking proactive steps to help prevent cardiovascular disease through health initiatives is not only socially responsible, but also a strategic business decision.
While employers may believe their current processes are effective, by establishing educational and preventative health programs to address cardiovascular disease, employee health may improve and company costs may be reduced. The CDC conducted a study of nine organizations with workplace health management
A leading cause of disability and the nation’s costliest medical condition, no other disease has a greater impact on the health of the workforce and the balance sheet as cardiovascular disease. Lifestyle changes can help prevent cardiovascular disease in many individuals. However, some individuals are either unaware that they are at risk or do not how to reduce their risk. By providing health promotion programs, individual risk assessment, tailored health messages or incentives to maintain a healthy lifestyle, employers may be able to help employees attain cardiovascular health while also improving their own bottom line.
You can also learn more by signing up for the Neace Lukens Employee Benefits newsletter here.