Larry Sherwood & Associates, Inc.

April 2012

Larry — Mon, 23 Apr 2012 18:17:46 +0000

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.

March 2011

Larry — Wed, 28 Mar 2012 17:53:44 +0000

Larry Sherwood & Associates – Your Voice In Washington D.C.

In January, LSA representative Michael Welch RHU, REBC took client concerns to the Capital. During the three day conference he met with Oregon elected officials and presented ideas to lower the cost of medical insurance for Oregon businesses. Ideas that would help control future rate increases and help sustain our current employer based delivery system. Mike's observation: "It was interesting this year as it seems our elected officials were a little more open to our ideas. Whether the result of a new spirit of compromise in D.C. or the fact that it's an election year for many officials". In either case LSA will continue to participate so that our client's voice is heard.

22nd Annual Capitol Conference Notes

Two Years Later; What Have We Really Accomplished?

Two years after President Obama signed the Patient Protection and Affordable Care Act, some provisions have taken effect, while others still have two years to wait.

In a recent poll by the non-partisan Kaiser Family Foundation, two in three Americans said the law has not affected them yet. Only 14% said they have benefited; 21% said they have been affected negatively.

Impacts of the Affordable Care Act

New Guidance Released For Employers on Health Benefit Informational W-2 Reporting

Last week, the Internal Revenue Service issued new guidance for employers detailing how PPACA's requirement that employer provide employees with informational reporting to their employees about the cost of their group health insurance coverage on W-2 statements must be fulfilled.

New Guidance Released For Employers on Health Benefit Informational W-2 Reporting

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

October 2011

Larry — Mon, 03 Oct 2011 19:01:31 +0000

Oregon Prescription Drug Program Offers Discounted Medications for All Oregonians

The Oregon Prescription Drug Program joined the Washington Prescription Drug Program to form the Northwest Prescription Drug Consortium. Through the combined purchasing power of the Consortium both states have benefited from substantial savings on their purchases of prescription medications. This unique program offers Oregonians uninsured, insured and underinsured the opportunity to purchase prescription drugs at deeply discounted rates. The best part, enrollment is free. The link below will take you to the home page for more information.

Read Full Article Here

The Healthy Kids Program Low or No Cost Coverage for Children

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. Coverage lasts for one full year and covers all health needs, including doctor visits, dental care, vision, mental or behavioral health services, prescriptions, and more. Children will not be turned away due to pre-existing conditions or be put on a waiting list.

No family makes too much money for Healthy Kids. Family income will determine whether a child is eligible for the no-cost, low-cost or full-cost coverage option. For example, a family of four earning as much as $67,200 a year may qualify for low-cost option.

The Office of Healthy Kids is a part of the new Oregon Health Authority, and enrollment work is done online or through the Department of Human Services offices across the state. Funding for the Healthy Kids expansion comes from a one percent premium on insurance companies and from matching federal funding for children's health insurance.

Oregon Health Kids Website

Obama Administration Shelves Long-Term Care Plan

The Obama administration has shelved a financially troubled long-term care insurance plan. Officials said Thursday the staff has been cut and it's an "open question" if the program will be implemented.

Known as CLASS, the Community Living Assistance Services and Supports program was created under President Barack Obama's health care law as a voluntary long-term care insurance program for workers. Doubts about its financial viability were raised early on and it has since languished in bureaucratic limbo, with Republicans in Congress pushing for repeal or defunding.

Read Full Article Here

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

August 2011

Larry — Wed, 03 Aug 2011 18:57:36 +0000

Your Tax Dollars Well Spent!

Larry Sherwood & Associates is constantly sourcing information about healthcare reform and PPACA to stay abreast of current events and to enlighten our clients. A valuable resource close to home is worth sharing. The link below will take you to the OREGON HEALTH CONNECT website. There you will find information about federally-funded clinics, healthcare reform, the basics of insurance, healthy living and much more. It's worth a look. Of course you can always lean on the resources on the other end of 503-293-6440!

Oregon Health Authority

Women's Preventive Services

Under the Affordable Care Act, women's preventive health care such as mammograms, screenings for cervical cancer, prenatal care, and other services is covered with no cost sharing for new health plans. However, the law recognizes, and HHS understands the need to take into account, the unique health needs of women throughout their lifespan.

Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012.

Health Resources and Services Administration

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

June 2011

Larry — Fri, 03 Jun 2011 18:49:52 +0000

Massachusetts Health Insurance Exchange Offers Lessons for Oregon

Recently the Oregon Legislature passed a bill that laid the groundwork for what will become Oregon's Health Insurance Exchange (an artificial marketplace for individuals and small businesses to purchase healthcare). The former Director of the Massachusetts Exchange recently spoke in Oregon about the successes of their program. The article is perhaps not as interesting as the commentary that followed. It's certainly an interesting point/counterpoint on the whole issue of exchanges!

Massachusetts health insurance exchange offers lessons for Oregon

Tax Benefits to Sole Proprietors for Healthcare Reimbursement Arrangement Plans

For both employers and employes HRA's can have financial advantages. Typically these advantages have not been available to owners and sole proprietors. This article highlighs how everyone can take advantage of HRA's.

Tax Benefits to Sole Proprietors for Healthcare Reimbursement Arrangement Plans

Who is the Most Profitable Insurer in Oregon?

Each year the Department of Consumer and Business Services, the state agency who oversees the insurance industry reports on the health of Oregon insurers. The attached report gives some very detailed information about the financial health of insurers.

Highlights…
-By 2019 healthcare expenditures will account for almost 20% of GDP and the average American will consume $13,650 of health care
-17.3% or Oregonians are uninsured
-Oregon's 7 largest insurers spent, on average, $0.91 of every dollar on claims payments
-Average annual small group rate increases in Oregon 2008: 13.4%, 2009: 10.4%, 2010: 11.68%
-Federal healthcare reform accounted for about 4% of medical premium increases in 2010
-From 2007-2009 Oregon insurers lost 15% of its membership, led by Lifewise (-20%)
-The average insurer profits of Oregon's 7 largest insurers 2007: 2.4%, 2008: .7%, 2009: 1.1%, YTD: 2.9%
-10 year average profit margin: most profitable Providence (4%), least profitable: ODS (0%)
-The least efficient insurer: Lifewise spending almost 14% of premium on "administration"
-Providence, Regence and Lifewise show the best investment returns earning 3% YTD

Full Report

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

May 2011

Larry — Tue, 17 May 2011 18:00:23 +0000

Decreasing Healthcare Costs: Is There Hope on The Horizon?

Much of the current wrangling over the creation and installation of the healthcare reform bill focuses on regulations, which have little hope of bending the medical cost curve. Most of it is tantamount to rearranging deck chairs on the titanic, unless we fix the cause of the leak we're all going under. Modifying the way in which physicians are organized (or in most cases not organized) and tying their pay to performance and outcomes may hold the key to stabilizing your insurance premiums.

21st-Century Health Care The Case for Integrated Delivery Systems

Federal Government Issues New Health Reform Notices

The first quarter brought a wave of new activity at the Federal level as government agencies issued guidance including a range of notices affecting various provisions of the Patient Protection and Affordable Care Act of 2010.

Federal Government Issues New Health Reform Guidance and Notices

Medicare Part D: updated notices issued by CMS

Do you provide prescription drug coverage to individuals eligible for Medicare Part D? If so, check out the updated model notices issued by the Centers for Medicare and Medicaid Services (CMS). The new model notices, for use after April 1, 2011, satisfy the requirement that a group health plan notify Medicare-eligible individuals whether the plan constitutes "creditable coverage" under Medicare Part D. Although there is no requirement to issue the notices in a foreign language, Spanish versions are available. This notice must be sent annually, upon request of a Medicare beneficiary, when a Medicare-eligible individual joins your plan or whenever your plan changes from creditable or noncreditable coverage status.

Model Notices

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

March 2011

Larry — Thu, 10 Mar 2011 17:30:53 +0000

A Riddle: What is Supported by the House, Senate and President Obama, Yet Still Going Nowhere?

If you answered legislation to repeal the new 1099 reporting requirement on U.S. businesses included in PPACA, you're a winner! Unfortunately, for business owners, the prize is just another month of worrying about how you're going to account for the new requirements.

A Riddle: What is Supported by the House, Senate and President Obama, Yet Still Going Nowhere?

Big Biz Says Dropping Insurance Isn't All It's Cracked Up to Be

Whether an employer continues to offer health insurance once state-run insurance exchanges take effect in 2014 will largely depend on the size of the employer, according to a survey by Mercer. Several factors are likely to play into an employer's decision including; tax status, penalty levels and subsidies. While the state of Oregon is generally ahead of other states in the formation of our exchange it is, as yet, unclear how this will play into an employer's decision to offer coverage.

Big Biz Says Dropping Insurance Isn't All It's Cracked Up to Be

Free Care at Oregon Hospitals Tops the Charts

Oregon hospitals are feeling the crunch of lower reimbursement rates, a shrinking commercial insurance market and a spike in uncompensated care. Here are some of the findings presented in the 2010 report:
-The commercial insurance market shrank by more than 3% in 2009, as businesses have been forced to downsize their workforce in response to declines in the economy.
-Government-sponsored health insurance increased in a nearly proportionate amount, almost 3%. Now, more than 54% of the patients coming through hospital doors are enrolled in Medicare and/or Medicaid, further exacerbating the cost pressures on the commercial market.
-Annual statewide uncompensated care surpassed $1 billion for the first time, reaching a total of $1.2 billion in 2009. This is a $219 million increase over 2008, a 22% increase year over year.
-Operating margins statewide only grew less than 1% (0.61%) in 2009. This reflects the reduction in workforce and service lines many hospitals enacted over the last 12-month period.
-By year's end, 35% of Oregon's acute care facilities had negative operating margins.

Free Care at Oregon Hospitals Tops the Charts

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

February 2011

Larry — Fri, 25 Feb 2011 19:11:59 +0000

LSA HEADING BACK TO D.C. FOR MEETINGS WITH OREGON LAWMAKERS

Michael Welch RHU, REBC, an agent with Larry Sherwood & Associates, recently met with lawmakers in Washington D.C. to share ideas about Healthcare Reform. Mike's goal was to discuss solutions that can affect how Healthcare Reform is implemented and measured, while keeping provisions for health promotion, quality outcomes and cost containment. Meetings were scheduled with both Oregon senators (Wyden & Merkley), and all 5 congressman. We'll inform you of the meeting outcomes in a future newsletter.

COMPLIANCE WITH IRS NON-DISCRIMINATION RULES DELAYED

If you sponsor an insured, non-grandfathered group health plan, there is some good news! The IRS has officially delayed the effective date of the impending nondiscrimination requirements for insured plans until after regulations or other administrative guidance can be issued (IRS Notice 2011-1). In addition, the IRS anticipates that any future guidance will not apply until the first plan year beginning some specified time period after issuance of the guidelines. The nondiscrimination mandate for insured plans is part of the Federal Patient Protection and Affordable Care Act (PPACA). The rules were to have been effective for calendar year plans on January 1, 2011, but this guidance gives plans a bit more breathing room. Plans offering different contribution schedules, "classed" benefits, or differing eligibility requirements are specifically impacted. If you have questions about how the nondiscrimination rules could affect your plan, contact Larry Sherwood & Associates.

IRS Notice 2011-1

JUDGE RULES OBAMA HEALTHCARE LAW UNCONSTITUTIONAL

A Florida judge dealt President Obama's healthcare overhaul another legal blow earlier this month. The ruling that the entire law is unconstitutional due to a requirement in the legislation that all Americans obtain health insurance starting in 2014. U.S. District Judge Roger Vinson's decision goes beyond a separate ruling by a federal judge in Virginia who ruled the individual mandate “unconstitutional”.

While the ultimate fate of the individual mandate and possibly President Obama's signature legislation seems destined to ascend to the Supreme Court, Republicans are pushing forward with their own "dismantle and deny" strategy.

Judge rules Obama's health care law unconstitutional

Here's how GOP wants to 'prune' health care law

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

December 2010

Larry — Thu, 23 Dec 2010 22:48:50 +0000

New 2011 W2 Tax Reporting Requirement

Beginning in 2011 employers will be required to report the value of health benefits to the IRS. This means payroll systems beginning February 2011 will need to be able to calculate and report partial year values for terminating employees. The attached ruling from the IRS does a nice job of explaining the provision.

Health Insurance Reporting Requirements

Happy Holidays From Larry Sherwood & Associates
	A year full of big healthcare changes is behind us. We look forward to another interesting year. Best wishes for a healthy and enjoyable holiday season and a bright 2011. From all of us at Larry Sherwood & Associates, Happy Holidays!

November 2010

Larry — Tue, 30 Nov 2010 22:38:58 +0000

A Simple Guide To Healthcare Reform
	"Health Reform Hits Main Street" is a short cartoon presented by the Kaiser Family Foundation that takes the 2,500 pages of the healthcare reform law and explains it in a simple and humorous way. While far from comprehensive, it does a nice job of outlining the issues we face. http://healthreform.kff.org/

Healthcare Reform: Prove It Works And Medicare Will Pay

Recent polls show that roughly half of Americans favor repealing some or all of the Patient Protection and Affordable Care Act (PPACA), presumably because they believe the law will do little to lower the cost of healthcare. However, there are actually some elements of the law that may lead us to that end. Buried in the new law is millions of dollars for funding Comparative Effectiveness Research (CER). In plain English, CER is a concept of paying for medical services that are proven cost effective. This article is a nice summary of a concept that holds real promise for reducing the cost of care.

http://www.kaiserhealthnews.org/Stories/2010/October/05/ft-health-care-reform.aspx

Introducing the New LSA Website!!

Take a look at our new website! It was designed with "you" in mind. With our new website you can:

- Research and apply for Individual & Family Insurance online

- Look up doctors and facilities for your insurance companies

- Find answers to many of your insurance questions

- Access past LSA Newsletters

- And much more information

Take a quick "test drive" by clicking the link below.

http://www.larrysherwood.com/