Current Healthcare News

• Grandfathered Plan Requirements / June 22, 2010

  New Healthcare Reform law establishes that individual and group plans that were in place on March 23, 2010 will not have to comply with all of the new law's insurance market provisions.  No new policies sold after March 23, 2010 will be considered grandfathered.  Need more details?  Click here to read more from our friends at the National Association of Health Underwriters.

• Scammers Use Promise of Medicare Rebate Checks to Steal Personal Information / June 11, 2010

  The Kaiser Family Foundation reported in its Health News that the Illinois Attorney General is warning that scammers are trying to trick Medicare-eligible seniors into revealing personal information in order to get a rebate check. "The first $250 rebate checks are being mailed this week to seniors in Medicare's drug coverage gap, known as the 'doughnut hole.'" The checks are being sent out automatically, so any request for information is a con (6/10).
  
  "Federal officials say they're already hearing reports that scam artists have called seniors and other Medicare beneficiaries, telling them they need to provide personal information to get the checks — including Medicare, Social Security or bank account numbers," the Chicago Sun-Times reports. "Not true. Seniors don't need to provide any personal information. The checks are being mailed automatically to eligible Medicare recipients" (Thomas and Knowles, 6/10).
  
  For the full story, click here.

• IRS Gives Guidance on Small Business Tax Credit / May 17, 2010

  The Internal Revenue Service issued new guidance to make it easier for small businesses to determine whether they are eligible for the new health care tax credit under the Affordable Care Act and how large a credit they will receive. The guidance makes clear that small businesses receiving state health care tax credits may still qualify for the full federal tax credit. Additionally, the guidance allows small businesses to receive the credit not only for regular health insurance but also for add-on dental and vision coverage.
  
  In general, the credit is available to small employers that pay at least half the cost of single coverage for their employees in 2010. The credit is specifically targeted to help small businesses and tax-exempt organizations that primarily employ moderate- and lower-income workers.
  For tax years 2010 to 2013, the maximum credit is 35 percent of premiums paid by eligible small business employers and 25 percent of premiums paid by eligible employers that are tax-exempt organizations. The maximum credit goes to smaller employers -- those with 10 or fewer full-time equivalent (FTE) employees -- paying annual average wages of $25,000 or less. The credit is completely phased out for employers that have 25 FTEs or more or that pay average wages of $50,000 per year or more. Because the eligibility rules are based in part on the number of FTEs, not the number of employees, businesses that use part-time help may qualify even if they employ more than 25 individuals.
  
  Eligible small businesses can claim the credit as part of the general business credit starting with the 2010 income tax return they file in 2011. For tax-exempt organizations, the IRS will provide further information on how to claim the credit.
  
  For a copy of Notice 2010-44, go to:
  http://www.irs.gov/pub/irs-drop/n-10-44.pdf
  
  For a copy of the step-by-step guide, go to:
  http://www.irs.gov/pub/irs-utl/3_simple_steps.pdf
  
  For a copy of the answers to frequently asked questions, go to:
  http://www.irs.gov/newsroom/article/0,,id=220839,00.html
  
  All are found on the Affordable Care Act page:
  http://www.irs.gov/newsroom/article/0,,id=220809,00.html
   

• Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses / May 10, 2010

  The United States Department of Labor just released:   The Affordable Care Act allows young adults to stay on their parents' health care plan until age 26. Before the President signed this landmark Act into law, many health plans and issuers could and did in fact remove young adults from their parents' policies because of their age, leaving many college graduates and others with no insurance. This helps to explain problems like:

  read more

• Impact of Healthcare Reform on Dental Benefits / May 3, 2010

  Since the Patient Protection and Affordable Care Act was signed into law, those throughout the health care system, as well as the media, have been primarily focused on the near-term impact that reform will have on individual and group medical benefits. What hasn't received as much coverage is how dental benefits will ultimately be impacted by the new reform law.
   

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• COBRA Premium Reduction / April 16, 2010

  FACT SHEET:  (U.S. Department of Labor)  The American Recovery and Reinvestment Act of 2009 (ARRA), as amended, provides for premium reductions for health benefits under the Consolidated Omnibus Budget Reconcilation Act of 1985, commonly called COBRA.  The premium assistance is also available for continuation coverage under certain State laws.  "Assistance Eligible Individuals" pay only 35% of their COBRA premiums; the remaining 65% is reimbursed to the coverage provider through a tax credit. 

  Read more

• FREE Healthcare Reform Webinar! / April 15, 2010

  Attention business owners and executives!  Do not miss this FREE informational (previously recorded) webinar; it’s your chance to learn more about the key elements of healthcare reform and how it will affect your business.
  
  Larry Grudzien, Attorney at Law, gave a thorough presentation on April 15, 2010.  Click here to register for a link to this interesting webinar.  Larry has over 28 years of experience; he practices exclusively in the field of employee benefits including experience in qualified plans, health and welfare, fringe benefits and executive compensation areas. Larry brings insight to business owners on the specific effects healthcare reform may have on their business.

  Learn more about:

  • The overall $940 billion plan is projected to extend insurance coverage to roughly 32 million additional Americans.
  • All individuals not covered by Medicaid or Medicare are required to obtain health care coverage or pay a penalty.
  • Larger employers must offer health care insurance for employees or pay a tax penalty (to the tune of $2,000 per full-time employee, excluding the first 30 employees)
  • There will be a new health insurance exchange for uninsured and small businesses
  • Medicaid will be expanded to 16 million people Insurance companies can no longer deny coverage for pre-existing conditions
  • Young adults will be able to stay on their parent’s plan until age 26
  • Insurance companies cannot place a lifetime cap on health care benefits

  If you have any additional questions about this webinar or the registration process, please contact Yana Kaykov at 630.371.6212.
   

• A Timeline of When Health Care Reform May Affect You / March 23, 2010

  (CNN) -- President Obama signed sweeping health care reform into law this week.  The Senate must now pass a package of changes that will reconcile the differences between Senate and House bills.   If those changes are worked out, here is how health care reforms will affect you:

  Within the first year

  read more

• Will You Be Penalized in Taxes as Part of the New Law? / March 24, 2010

  Tax season is here! This is a friendly reminder that employees who added dependents under the Illinois Public Act 95-0958 (that went into effect on June 1, 2009) may incur additional taxable income. As you may know, only certain dependents may qualify to receive employer-provided health coverage on a tax-free basis. If coverage is provided to a dependent who does not meet the IRS definition of a “qualified tax dependent” (per Sections 152 and 105(b) of the Internal Revenue Code), federal income and payroll tax consequences will result. In addition to post-tax payroll deduction, the employee will incur additional taxable income.
  
  If you find yourself in this situation, the amount of income on which the tax is calculated is determined by the fair market value of the employer-provided health benefits for the non-tax qualified dependents. This income will be subject to income withholding and payroll taxes such as Social Security and Medicare. Also mentionable: health care expenses for non-tax dependents are not reimbursable under a health care flexible spending account.
  
  Please remember to consult with your accountant, as soon as possible, if you may be in the aforementioned situation.
   

• Obama Signs Stopgap COBRA Subsidy Extension / March 3, 2010

  WASHINGTON-President Obama Tuesday night signed into law legislation that provides a stopgap, 31-day extension of federal subsidies of COBRA health care premiums.
  
  The measure was approved earlier Tuesday by the Senate on a 78-19 vote, while the House cleared it last week.
  Under H.R. 4691, the 65%, 15-month premium subsidy for laid-off workers is extended to those involuntarily terminated from March 1 through March 31.
  
  Without the extension, employees laid off after Feb. 28 would have been ineligible for the subsidy.  The measure also will allow employees to receive the subsidy if they first lost group coverage due to a reduction in hours and then were terminated after enactment of the legislation, if certain conditions are met.
  
  Meanwhile, the Senate Wednesday will continue consideration of legislation, H.R. 4213, that would extend the premium subsidy to employees laid off through Dec. 31, 2010.
   

• Go Red for Women This February / February 10, 2010

  The American Heart Association is offering a free 12 week makeover program (Better U) that can change your life. The program features an online nutrition and fitness program. Each week focuses on a different area and provides step-by-step guidance. Click here for more information.

• New COBRA Subsidy Extension Notices Available / January 14, 2010

  ARRA, as amended by the Department of Defense Appropriation Act, 2010 (2010 DOD Act), mandates that plans notify certain current and former participants and beneficiaries about the premium reduction.

  The Department created model notices to help plans and individuals comply with these requirements. Each model notice is designed for a particular group of qualified beneficiaries and contains information to help satisfy ARRA's notice provisions, including those added by the 2010 DOD Act.

  read more ...

• The Importance of an Annual Exam / January 1, 2010

  Annual physical exams are a vital part of a preventative illness measure taken to ensure a long and healthy life for you and your family. Parents often make certain their children receive an annual exam, however exams become increasingly important into adulthood. Nothing can replace the importance of daily exercise, maintaining a healthy weight and not smoking, but health professionals can use an annual exam to keep abreast of signs and symptoms that could lead to a serious illness.

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• COBRA Subsidy Extension Passed / December 16, 2009

  On December 16, 2009, the U.S. House of Representatives approved legislation extending the federal subsidy of COBRA health insurance premiums for employees who are involuntarily terminated. For beneficiaries whose nine-month COBRA premium subsidy has run out, an additional six months of subsidized coverage will be provided. This will apply to those who lose their jobs through Feb. 28, 2010.
  
  Also, the legislation will give beneficiaries whose subsidy ran out and who didn't pay the full premium a second chance to opt for coverage. For example, a beneficiary whose nine months of subsidized coverage ran out Nov. 30 and who didn't pay the regular unsubsidized December premium could pay the 35% premium share in January and receive coverage for December.
  
  Please note: Employers are required to notify current COBRA beneficiaries and future beneficiaries of the new 15-month premium subsidy.

  Benefits Solutions Group will keep its clients apprised of any changes as they occur. If you have any questions, please feel free to contact your Benefits Representative at 630-928-0500.
   

• COBRA and State Continuation Subsidies Ending / November 30, 2009

  The American Recovery and Reinvestment Act provided eligible COBRA and state continuation participants with nine months of subsidized premiums, beginning with the first wave on March 1, 2009. These first participants will be past their nine-month mark at the end of November 2009. They will then be responsible for paying 100 percent of their premiums beginning December 2009. For some, the increase will be a significant financial drain; particularly for those who have lost track of the nine-month end date. Subsequent waves of the nine-month subsidy period will expire for participants monthly from here on out.
  
  Employers and group administrators should anticipate an increase in calls from impacted participants concerned with the ability to pay the premiums and an increase in member terminations due to unpaid premiums.
  
  Employers currently receiving federal subsidy reports will continue to receive those reports as long as they have participants receiving the subsidy. The subsidy program will end on December 31, 2009, for any new applicants. This means, assuming there is no extension, the final wave of the nine-month subsidy period will end on September 30, 2010. The government, however, is currently considering an extension of the subsidy program. We will monitor this possibility and post any changes to our web site.
   

• H1N1 - How can employers prepare? / October 22, 2009

  According to the Center for Disease Control, if you do contract the H1N1 virus you may be ill for a week or longer.  If you are ill, you should stay home and keep away from others as much as possible.  Avoid travel and do not go to work or school for at least 24 hours after your fever is gone. 
  
  For more information on flu prevention, vaccination, and signs you should seek medical attention - click here.

• Changes to Dependent Coverage / June 1, 2009

  Effective June 1, 2009, there will be changes to the dependent coverage provision for health and dental plans issued in Illinois pursuant to the Illinois Public Act 95-0958.  All group health insurance policies amended, delivered, issued or renewed on and after June 1, 2009 and that provide coverage for dependents must allow for dependent coverage of eligible unmarried dependents up to age 26.  In the case of eligible unmarried dependents who have served as a member of the active or reserve components of any branch of the United States Armed Forces, up to age 30.  Based on this new law, full-time student status up to age 25 is no longer required and dependents who meet the definition of disabled will continue to be covered without the age limitation.
  
  If employees have any dependents who meet these criteria and who are not currently enrolled under their policy, they may elect to enroll the dependent during open enrollment.  Contact your Benefits Solutions Group representative or insurance company for more information.
   

• Insurance Coverage for Autism / December 12, 2008

  A new law (Public Act 95-1005) went into effect on December 12, 2008. If your insurance policy was issued or renewed after this date, the coverage for Autism may have changed in your policy. All individual and group policies as well as HMO contracts must include psychiatric, psychological, habilitative or rehabilitative and therapeutic care for those with Autism under the age of 21 up to $36,000 per year. Click here for more information about coverage, limits and your legal rights or read the full text of Public Act 95-1005.

• New Mental Health Parity Act / October 3, 2008

  On October 3, 2008 the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 went in to effect. The Act requires group health plans providing mental health and substance abuse benefits to ensure that coverage of these benefits is equal to the plans’ coverage of medical and surgical benefits. This Act substantially increased the mental health benefits protection afforded under the federal Mental Health Parity Act of 1996, which only require parity coverage for lifetime and annual dollar limits and did not apply to benefits for substance use disorders. Click here to read more details about the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Click here for full text of Act.