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January 2014

January 20, 2014 by  
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News Bulletin For January 2014

 

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 

 

Research Lower Cost Options 

 
 

 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 

 

If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.

 

 

Dear Larry,

The world of benefits is constantly changing.  Keeping up with all of the new health insurance regulations is a full time job even for your broker.  We have condensed volumes of reading into this short briefing.  The following articles are a few of the highlights of what we have been following.

 
Sincerely,

Larry Sherwood    

THE NEXT EVOLUTION OF HEALTH BENEFITS?

As benefit trends go I suppose we could say it's "Back to the Future" all over again. Although this time the theme may be more defined and more pronounced. Narrow-network plans are pretty much exactly what they sound like; trading a smaller provider panel for lower premiums. It's a trend we saw emerging a couple of years ago and have been educating our clients on for some time. The emergence of narrow-network plans should be accelerated by Obamacare as one way to drive down costs. In Oregon we have been exposed to the original 'narrow -network' plan for years. The Kaiser model is, perhaps, the best example of a narrow-network. The attached article does a nice job of explaining exactly what they are and why they exist. Adoption rates and longevity may depend on how much savings are presented by these plans. Locally almost every insurer offers some form of a narrow-network plan including, Health Net, Regence Blue Cross, United Healthcare, Lifewise and of course Kaiser. To find out how these plans work and whether or not they could benefits your company contact us.

Narrow Network Article  

HEALTH EXCHANGE ENROLLMENT PICKED UP IN DECEMBER   

Nationally, enrollment in state or federally facilitated healthcare 'exchanges' has fallen below targets. This is likely due, to the difficulties experienced by the electronic marketplaces and exacerbated by endless negative press. That being said, it is January and perhaps the realization that our federal government is requiring each individual to carry minimally acceptable health insurance is driving enrollment. Nearly 2.2 million people picked a health insurance plan through the exchanges established by the Affordable Care Act through Dec. 28. This is about 65 percent of the administration's goal for this period. After a rocky start, enrollment picked up with more people signing up in December than in the first two months combined.

 

NY Times Article

USA Today Article 

COVER OREGON UPDATE  

Oregon's health insurance marketplace is still limping along with a partially functional website and enrollment lagging well behind even conservative estimates. It's interesting that Oregon, a state that jumped on board early in the process and the recipient of millions of dollars of federal "Early Innovator" grants, is among the worst performing states in terms of enrollment. Better only than Massachusetts and Hawaii. The commonality of note between those states is that both have forms of mandated coverage. Hawaii and Massachusetts are #1 and #2 in number of insured citizens. In other words we are better than only the two states that needed the mandate the least.

 

Lund Report Article 

Statesman Journal Article 

 

October 2013

October 29, 2013 by  
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News Bulletin For October 2013
Quick Links

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 
The world of benefits is constantly changing.  Keeping up with all of the new health insurance regulations is a full time job even for your broker.  We have condensed volumes of reading into this short briefing.  The following articles are a few of the highlights of what we have been following.

AFFORDABLE CARE ACT – PREMIUM ASSISTANCE CREDIT VIDEO OVERVIEW 

Congress has provided an insurance subsidy in the form of a tax credit or premium reduction to help qualified lower-income individuals and families pay for the cost of the insurance. This video link provides an overview.

SMALL BUSINESS HEALTH CARE TAX CREDIT FOR SMALL EMPLOYERS   
The Small Business Health Care Credit is designed to help employers provide health insurance coverage to employees. The credit can be up to 35% of employer paid health insurance premiums; eligible tax-exempt employers may get a 25% credit.  The link below is a good resource for our small business clients. As always, we recommend you consult a tax professional for final determination.

EMPLOYER HEALTH BENEFITS –
2013 SUMMARY OF FINDINGS
 

Employer sponsored insurance covers about 149 million non-elderly people. To provide current information about employer-sponsored health benefits, the Kaiser Family Foundation and the Health Research & Education Trust conduct an annual survey of non-federal private and public employers with three or more workers. This is the fifteenth survey and reflects employer sponsored health benefits in 2013.

Some interesting findings:

  • 58% of covered workers at small firms (3-199) now have a deductible of $1,000 or more
  • 77% of firms offer at least one wellness program
  • In 2013 the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage
  • Covered workers contribute on average 18% of the premiums for single coverage and 29% of the premiums for family coverage
  • Workers in firms with a higher percentage of lower-wage workers contribute higher percentages of the premium for single coverage (23% v. 17%)
  • The average annual premium contributions in 2013 are $999 for single coverage
  • PPO plans remain the most common plan type, enrolling 57% of covered workers
  • Among covered workers with a general annual deductible, the average deductible amount for single coverage is $1,135
  • For In-Network office visits, covered workers with a copayment pay an  average of $23 for primary care and $35 for specialty care

Summary of Findings

August 2013

August 29, 2013 by  
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News Bulletin For August 2013
Quick Links

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 
The world of benefits is constantly changing.  Keeping up with all of the new health insurance regulations is a full time job even for your broker.  We have condensed volumes of reading into this short briefing.  The following articles are a few of the highlights of what we have been following.

WHITE HOUSE TOUTS SLOW INCREASE IN HEALTH CARE COSTS

Now for some good news about the state of health insurance. Personal healthcare costs rose in the 12 months ending in May at the slowest rate in the last 50 years, as spending on hospital and nursing home services declined, the White House announced Monday. This is a trend that LSA has been observing over the past 14 months.   The bad news, fees, taxes and assessments associated with the Affordable Care Act are certain to add another 6-8% onto increased healthcare costs. For a further explanation of those fees, contact your broker here at LSA.

NOTHING ANYBODY SAYS ABOUT OBAMACARE MATTERS. REALLY!  

A fair amount of time will be spent covering the war of words and commercials and campaign events over Obamacare as we get closer to the law's October 1st launch date. But to put a marker down, almost nothing anybody says about this law between now and then matters. Really.

That's been true for years now. Look at this graph of the Kaiser Family Foundation's healthcare tracking poll. Really study it. Opinions on Obamacare have been basically stable since 2010. That's been true despite all the rhetoric and all the elections and all the Supreme Court decisions and all the ads. The law has been slightly unpopular for three years. There's never been a sustained period in which it became popular, or very unpopular.

The most notable trend on that graph, in fact, is that over the last six months or so, both the "favorable" and "unfavorable" numbers have fallen and "don't know/refused" has risen. So that's been the main outcome of this war for public opinion: A slightly larger proportion of the country is confused about the Affordable Care Act. Congrats, spinmeisters.

This speaks to a broader truth about political rhetoric: The things people in Washington say always have less influence than people in Washington think. It's true when presidents are talking. It's true during national campaigns. And it's even truer for the continuing, bitter war over the health-care law, which everyone but real obsessives has tuned out.

July 2013

July 30, 2013 by  
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Special News Bulletin For July 2013
Quick Links

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 
 
DELAY IN HEALTHCARE REFORM 
 

In a surprise move yesterday the Treasury Department announced that the Obama administration will not penalize employers for failing to provide qualifying health insurance in 2014. This announcement comes as employers are making preparations for the bill's full implementation date of January 1, 2014. Little else is known about the effects of this announcement and we expect more from the Treasury Department and Health and Human Services in the coming days. We are monitoring this situation and will keep you updated as more information becomes available.

May 2013

May 30, 2013 by  
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News Bulletin For May 2013
Quick Links

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
Drake Park
 
HEALTH INSURANCE SUBSIDY CALCULATOR
Estimate impact based on; income, family size, age, and tobacco usage.  In last month's newsletter we suggested that millions of Americans will be eligible for subsidized healthcare.  In this month's newsletter we include a calculator so you can determine if, and how much, you might be eligible to receive based upon your specific situation.  Remember, the key to receiving any subsidy is you do not have access to affordable, minimally acceptable coverage elsewhere, ie. your employer, Medicare, Medicaid and/or Tricare.  If a person has access to "affordable" coverage that meets minimum standards they will not be eligible to receive a federal subsidy.
For more information contact our office.

NOTICE OF EXCHANGE ADDS ANOTHER PPACA EMPLOYER REQUIREMENT

As part of the Affordable Care Act (ACA) all Oregon employers are required to notify their employees about Oregon's Insurance Exchange, Cover Oregon.  While this notice requirement was originally scheduled to be implemented by March 1, 2013, the U.S. Department of Labor extended the deadline to October 1, 2013.  We recommend you advise your employees that Cover Oregon (www.coveroregon.com) will begin operations on October 1, 2013 and they might, personally, benefit under the new health insurance regulations beginning January 1, 2014.  Included for your reference are two forms to assist in compliance.  The first is for employers who currently offer medical coverage and the second is for those who do not have not plan in place. We have also included the D.O.L. guidelines issued May 8th for those who seek greater knowledge about this requirement.


Employer Exchange Notification – With Health Plan

Employer Exchange Notification – Without Health Plan

DOL Employer Exchange Notification Guidelines  

ONE OF OUR FAVORITE RESOURCES FOR HEALTHCARE REFORM INFORMATION

We have also found an excellent resource created by one of our local insurers, PacificSource, that explains how the ACA affects consumers and employers.  We are constantly searching for information about the PPACA from a multitude of sources. This particular resource is one of our favorites. It does a very nice job of crystallizing this behemoth of a law into an easy to understand format.

  

April 2013

April 29, 2013 by  
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News Bulletin For April 2013
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Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 
Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 

MORE GUIDANCE ON HEALTHCARE REFORM'S EMPLOYER "PLAY OR PAY" MANDATE
 

Callan Carter is an accomplished, highly regarded ERISA and employment law attorney and also a friend of our agency. We often rely on her for guidance with your questions. She also has a knack for simplifying complex subjects like the PPACA. The attached article is a nice summation of the "Play or Pay" mandate.

MILLIONS ELIGIBLE FOR HEALTHCARE SUBSIDIES, BUT MOST DON'T KNOW IT

Nearly 26 million Americans could be eligible for health insurance subsidies next year, but most don't know it. Information about these subsidies will be coming fast and furious as Cover Oregon, our state-run exchange, ramps up enrollment efforts later this year. Larry Sherwood & Associates, Inc. will be an endorsed enroller and as such can guide both you and your employees through the enrollment process. Questions? Give us a call.

2013 FEDERAL POVERTY GUIDELINES
Federal subsidies for the purchase of medical insurance are available beginning in 2014 for anyone within 400% of the Federal Poverty Level (FPL). Anyone ever wonder what those FPL numbers look like? Attached is a state-by-state listing.
 
 
 

March 2013

March 25, 2013 by  
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News Bulletin For March 2013
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Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
Drake Park
 
OREGON INSURANCE EXCHANGE UPDATE

On October 1, 2013 Oregon's insurance Exchange (known as Cover Oregon) will begin enrolling individuals and small businesses (less than 50 employees) for January 1, 2014 effective dates. While the details of what is being offered, which insurance companies will participate in the exchange and the specifics of the enrollment process are all still works in progress, we can tell you about the exchange on a broader level.

For purposes of simplification, think of Cover Oregon as another insurance company option to provide your employee benefits. They will likely offer several plans from many different insurance companies, but Cover Oregon will assume no actual financial risk. Essentially, their role as "benefits administrator" will be to negotiate rates and plans and to offer centralized administration for billing and payment purposes.

Companies and individuals may choose to secure benefits through the Exchange, although federal law dictates that identical plans offered in and outside of the Exchange must be identical in price. So if the plans are the same and there is no difference in pricing what is/are the advantages of purchasing thru the Exchange? As we see it there may be two potential advantages of the Exchange:

  1. The ability to offer more than one insurance company. Most employers under 50 enrolled employees have the ability to offer more than one benefit plan but not more than one insurance company (i.e. Adding Kaiser as an alternative to your current Blue Cross option). This option may be a nice alternative for those employers who distain the current "one-size-fits-all" mentality.
  2. It's highly probable that the Exchange will be the only place that eligible employees may receive their government subsidy. As we have stated, employees who live within 100% – 400% of the federal poverty level will qualify for government assistance by way of a tax credit. The Exchange is an efficient way to administer and track these subsidies.

Larry Sherwood & Associates, Inc. is keeping a very close watch on the developments in Salem. What we want our clients to know is that we have every intention of becoming "Exchange certified" so that we can present our clients with every available option.

BITTER PILL: WHY MEDICAL BILLS ARE KILLING US

 This recent Time Magazine cover story takes a very in-depth look at the real problem with the American healthcare system; the cost of care. The article looks at how the medical industry has focused the public's attention on who should pay and away from how much we pay.  This expose' will help the reader understand how we, the consumer, pay for health services.  As we have said many times, the cost of health insurance is simply a reflection of the cost of the care consumed.  Settle in, it's a long read but well worth it!

 Full Article

THE PRICE OF OBAMACARE'S BROKEN PROMISES

The inflammatory headline aside, this article prepared by the House Committee on Energy and Commerce, the Senate Committee on Finance, and the Senate Committee on Health, Education, Labor & Pensions outlines the elements of the Affordable Care Act that will increase health insurance costs. The information provided draws its conclusions from several different partisan and non-partisan sources. LSA has been skeptical of initial claims that the PPACA would drive health insurance rates down. After reading this article we are even more assured of our position….unfortunately!

Full Report

  
 
 

January 2013

January 31, 2013 by  
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News Bulletin For January 2013
Quick Links

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is less expensive and a better value than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 
SMALL BUSINESS TAX CREDIT

Starting in 2010, up to 4 million small businesses offering healthcare coverage to their employees may be eligible for a tax credit.  Our experience suggests the small business tax credit may not be as beneficial as advertised.  You may determine how your organization may benefit from this element of the Affordable Care Act. Below is a link to start the process.

 

Tax Credit Calculator

PENALTIES FOR EMPLOYERS NOT OFFERING AFFORDABLE COVERAGE BEGINNING IN 2014
Much of our time has been spent analyzing the Affordable Care Act's "play or pay" scenario and determining the ramifications of this provision. "Should I offer coverage?"  "What happens if I don't?"  "What does 'affordable coverage' mean?"  The attached flow chart may be helpful.  As always, should you have questions, please feel free to contact our office for guidance.

2014 TAX COSTS HIT 2013 PREMIUMS
The healthcare reform law imposes a new tax on all fully insured health insurance products, increasing the cost of coverage for anyone with private insurance. The tax begins at $8 billion in 2014 and rises to $14.3 billion in 2018, increasing annually thereafter based on premium growth. The Joint Committee on Taxation projects that between 2013 and 2022 the new tax will total $101.7 billion. There is nothing in the law preventing health insurance carriers from passing this tax to consumers. In fact, we are seeing some of these increases in advance of the implementation of this tax.

The video link may be helpful in explaining the impact of this tax.  

 

America's Health Insurance Plan Video 

July 2012

July 12, 2012 by  
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News Bulletin For July 2012
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Supreme Outcome

After more than a year of uncertainty, we finally have closure with regards to the most significant constitutional challenge to Patient Protection and Affordable Care Act. Just in case you've been away from your television, radio and/or Internet source for the past few days, here is a quick recap of the ruling.

 
 
 

Healthy Kids

Healthy Kids provides no-cost, low-cost and full-cost health coverage options for uninsured Oregon children and teens up to 19 years of age.

Learn More

 
 
If a friend or associate forwarded our bulletin to you and you would like to join our mailing list, please click on the above link.
 
Don't Delay COBRA Notifications
Many clients choose to outsource COBRA and for good reason. It's a difficult law to completely comply with and most employers overlook important details.

A recent court case (Fama v. Design Assistance Corp.) shows why it's so important to stay compliant. In this case, an employee was terminated, but the employer didn't send a COBRA notice and mistakenly continued her coverage at no charge for 5 months. The employer retroactively canceled her coverage, but later reversed itself and reinstated the coverage at no cost to the employee. When the employee sued over the employer's mistake, the court awarded her nearly $3,000 in damages because the employer didn't provide her a COBRA election notice when it should have, despite the fact that she actually received 5 free months of coverage for which she wasn't entitled.

Larry Sherwood & Associates has several resources to help you comply with this complicated law.

 

Brand Name vs. Generic Prescriptions
If you have ever sat through an enrollment meeting from one of our agents you have undoubtedly heard us strongly recommend the use of generic medications. Not only will it help control rising medical premiums but it will also save employees money. Now one of Oregon's largest insurers has published an eye opening report about just how much difference there really is between generic and brand name medications. Think of the attached chart next time you visit your local pharmacy.

 

Alternative To Dependent Group Coverage

Maintaining coverage for dependents (spouses, children, domestic partners) can be cost-prohibitive for many employees on your group coverage. Oftentimes an individual plan for their dependents is cheaper than adding them to the group plan. Click the link below to begin research for lower cost dependent coverage. 


 

April 2012

April 23, 2012 by  
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23 and 1/2 hours: What is the single best thing we can do for our health?
It's long been known that one of the best things we can do to improve health and quality of life is to exercise daily. This fun and creative video explains this 'prescription' in a simple and entertaining manner.

Single Best Thing

 
Two of the biggest behind-the-scenes players in the health care industry have become one.
Express Scripts sealed its long-planned deal to buy Medco Health Solutions on Monday after the Federal Trade Commission voted 3-1 that it would not stifle competition in the industry. The two companies already provide prescription drug benefit services to some 135 million people (more than 1 out of every 3 Americans).

But while the FTC might not think the $29 billion union of Express Scripts and Medco threatens the market for how prescription drugs are distributed to patients, owners of brick-and-mortar drugstores certainly do.

Pharmacies Aren't Happy

 
 
Plans for Oregon health overhaul about to be clearer
SALEM, Ore. (AP) The Oregon Legislature has bought into Govenor John Kitzhaber's ideas for redesigning the state's health care system for low-income patients. Now, it's about to become plain how many Oregon doctors, hospitals and other care providers are ready to put his vision into practice.

Full Article

 
 
 
Larry Sherwood & Associates provides benefits consulting & insurance services to over 300 companies just like yours.

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