Resolve to Have a New You in the New Year

At Least a Healthier, More Relaxed You

(Washington, December 15, 2008)—Seventy-five percent of respondents polled in a survey conducted by VacationBetter.org this month, did not take all of their vacation this year, often foregoing it due to economic or work issues. As the New Year approaches, many of us make resolutions to lose weight, exercise more or do something that makes us look or feel better. The best resolution this year is to commit to taking an annual break to reconnect and recharge. Giving up vacation may actually cost you more in healthcare costs in the long run.

Perhaps it is time to follow New Year advice from a group of people that do tend to keep their resolution past January: timeshare owners. Studies show that there are undisputed, long-term benefits associated with taking regular vacations that contribute to better health, relationships and job performance. 2008 was the year of the “Staycation,” a new idea designed to make staying home sound like a good use of vacation time. Unfortunately, staying confined to the normal routines of daily life will not produce the long-lasting benefits of a traditional vacation.
“Put away the cell phone and laptop and disengage from the daily hassles of your life,” says John de Graaf, executive director of Take Back Your Time, an initiative encouraging time outside of work. “Our goal is to make 2009 the year we all actually take our vacations.”

Although Americans are experiencing tighter budgets, vacations should be viewed as a necessity rather than a luxury. Traveling with timeshare eases the necessity of vacation by taking the stress out of planning for one while accommodating every traveler’s desires. And, vacation ownership accommodations provide for better family time because people can participate in activities at their own leisure. Timeshare ensures this process will happen at least once a year, every year, which means a healthier, more relaxed life.

Everyone deserves a vacation in 2009, and not just a good one, but a better one. Go to http://www.vacationbetter.org/ to take a survey on your New Year’s goals.

Then go to:

AMS Travel Related Services and start planning today, book that special trip.

What to do should you need Unemployment Benefits

Unemployment is on the rise with more job cuts likely for 2009. Most economists believe this recession will continue until 2010. We hope they’re wrong and that this and that you or someone you know will need this information. If you or someone you know does then we hope this will help you or them.

A common question receive has to do with unemployment benefits and how to file for them.

There are a few things you should know that will help you get your benefits sooner.
First, make sure you’re eligible. To get unemployment benefits you must have been an employee, not a private contractor or any other type paid by 1099. If you received a W-2, you’re likely considered an employee.

Regulations and enforcement vary by state. California, for example, is very pro-employee while more conservative states like Ohio could side with the employer for some disputes.
Second, if you know that you’re eligible, submit the paperwork as soon as you can. There is a period of time between the request and the first check arriving so the sooner you apply, the better for your cash flow.

Third, be prepared to show you’re looking for work and to take a mandatory class. Unemployment classes are typical. They provide assistance in finding a job and also show that you’re being proactive with your search. If you don’t go to the class, you will not qualify for benefits. Check with the unemployment office in your state to see if there is a required class.
Fourth, know that your unemployment check is much less than your standard paycheck.

Unemployment is meant to keep you on your feet while you look for a new job.
Last, obviously unemployment does not last forever. You’ll eventually need to find a job because benefits will stop. The sooner the better.

*During this financial crisis some states’ unemployment funds are running dry. This would be a disaster for many. Although unemployment benefits have been a sound program for many years, we recommend not counting on it to pay the bills. Funds could run out depending on your state.

To find the local unemployment office in your state, search Google for unemployment office and state name. This search for the state of California returned this link to file a claim.

Health Care Costs Slowing and how each $ is spent!

Rates increased by 6.1 percent from 2006 to 2007, compared with 8.8 percent from 2004 to 2005 and 13.7 percent from 2000 to 2001. The growth rate for premiums can be attributed to general inflation (64 percent), health care price increases in excess of inflation (30 percent), and increased utilization of services (25 percent), according to the report.

The report also found that 87 cents out of every dollar goes toward medical services, including 10 cents that is dedicated to medical liability and defensive medicine. The remaining 13 cents is divided between consumer services such as health information technology (4 cents), administrative costs (6 cents), and profits (3 cents).

How to save on your health care costs with Consumer Directed Plans:

Health Savings Account Plans Explained …click here!

Get Ready for the Newly-Revised FMLA Regulations

The federal Family Medical Leave Act (FMLA) has been a significant and often challenging compliance obligation for many businesses nationwide. Recognized as one of the most crucial workplace issues for 2009, however, specific recent FMLA developments are anticipated to provide employers with new tools to help administer this type of leave more effectively. Within only about 3 months, employers subject to FMLA need to get familiar and get ready based on the revised regulations which become effective on January 16, 2009.

The FMLA Basics:
FMLA is governed by Federal law. Employers with 50 or more employees must grant up to 12 weeks of unpaid FMLA leave to their employees for certain qualifying events; health care benefits must be continued during FMLA leave; and the employee must be reinstated to his or her former position or an equivalent position at the end of the leave. Employees are eligible for FMLA leave if they have worked for the employer for the 12 months, have worked 1,250 hours or more in that period, and are at a work site where there are at least 50 employees within a 75 mile radius.

Employees must follow the company’s call-in policies if they plan to miss work “absent unusual circumstances.” Currently, employees have up to two days after an absence to notify the company about their need for leave.

An employee’s time spent performing light duty does not count toward FMLA entitlement.
Employers may consider additional medical information obtained through ADA, paid leave, or workers’ compensation procedures.

Employers may account for FMLA absences to determine bonus and incentive rewards.
The regulations interpret and implement the Military Family Leave Amendments enacted earlier this year.

The application of FMLA to professional employer organizations also is addressed.

In the midst of current economic uncertainties, incorporating and applying the revised FMLA regulations may be very frustrating for many employers. At the same, businesses simply cannot afford to ignore the issue. Employers must prepare, review, and update their policies, forms, etc. as needed to communicate clearly and effectively – verbally and in writing – with and for all of its employees.

Learn More by clicking on the HR Link:

A Value Added service available to AMS Clients.

Health Care in Retirement:

One of the most complex parts of your retirement paycheck is the cost of your health care. As you plan for your retirement, make your health a priority by getting acquainted with your healthcare options now. Medicare, the federal program that provides health insurance for people over age 65 is a health care lifeline to the millions who rely on it. As you consider what your future costs will be, keep in mind that not all Medicare services are free and not all medical services are covered by Medicare. So, as you plan, be sure you include the cost of health care—public and private insurance as well as out-of-pocket expenses. Estimating how much you will need in addition to Medicare can be difficult, because a lot of what you need to know to create a plan depends on guesswork.

For example, how long will you live? How healthy will you be? Will you have any “pre-existing conditions?” What will be the cost of Medicare Part B or a Medicare Advantage Plan when you reach age 65?

To help you get started, here is some information on how to supplement Medicare costs and where you can go for more information.

The ABCs of Medicare at:

The Official U.S. Government Site for People with Medicare

http://www.mymedicare.gov/


In your quest to create retirement savings through IRA’s, Roth IRA’s 401K’s and other retirement programs consider an HSA aka; Health Savings Account as an alternative. Unlike some company sponsored FSA or Section 125 plans the money in an HSA plan is yours, roles over year to year and any unused money from spending on Medical, Dental and Vision care will be there in Retirement.



Check out the Benefits here. Health Savings Account Plans Explained …or look into an IRA or 401K at: Pension Plans…

Employee Benefits: Health Plan Changes For 2009 And 2010

A number of new laws and regulations will affect the design and administration of group health plans beginning in 2009.

Change in Definition of Dependent

A "dependent" for purposes of group health plan coverage is typically defined by reference to section 152 of the Internal Revenue Code ("Code"), which describes dependent status based on whether an individual is a "qualifying child" or a "qualifying relative." Effective January 1, 2009, the Fostering Connections to Successful and Increasing Adoptions Act of 2008 changed the definition of "qualifying child" under Code Section 152(c).

Two new requirements are added to the definition of "qualifying child:"

1. The child must be younger than the taxpayer claiming the individual as a dependent; and

2. The child must not have filed a joint return (other than only for a refund claim) with the child's spouse for the taxable year in question.

The new law also allows a non-parent to claim the child as a dependent, as long as the parents do not, and the non-parent's adjusted gross income is higher than the highest adjusted gross income of any of the parents.

Massachusetts Creditable Coverage Requirements

Residents of Massachusetts must have health insurance that is "creditable coverage" or else pay a significant penalty to the Commonwealth. Regulations describing what constitutes minimum creditable coverage were recently issued by the Commonwealth Health Insurance Connector Authority. Although the regulations do not directly apply to group health plans sponsored by employers, an employer with a group health plan that is not "creditable coverage" will be under significant pressure from its employees to improve coverage.

Effective January 1, 2009, a health plan must provide "core services" (i.e., physician services, inpatient acute care, day surgery and diagnostic treatment and tests) and, at a minimum,


Preventive and primary care;

Emergency services;

Hospitalization;

Ambulatory patient services;

Prescription drugs; and

Mental health and substance abuse services.
Effective January 1, 2010, the list of required services increases.

The plan can impose reasonable exclusions and limitations, including different benefit levels for in-network and out-of-network benefits, as well as co-payments, deductible and co-insurance; however, limits apply. In addition, a health plan may not impose an overall aggregate annual maximum benefit limitation or an annual cap on core services. Further, preventive care services may not be subject to a deductible (co-payments or co-insurance consistent with primary or routine physician office visits are permissible).

The regulations do not address the date as of which "creditable coverage" is determined, so it is unclear whether mid-year amendments to a health plan to bring it up to the regulatory standards will avert the employee penalty. Finally, the regulations impose no requirement that employers inform employees whether the health plan is "creditable coverage," but employers should be ready to answer questions on the subject.

Mental Health Parity

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was enacted as part of the Emergency Economic Stabilization Act of 2008. Although the new law does not require group health plans to provide benefits for mental health and substance abuse, it requires those plans that offer both medical/surgical and mental health/substance abuse benefits to do so on an equal basis.


The financial requirements of the plan, such as deductibles and copayments, can be no more restrictive for mental health or substance use disorder benefits than those that apply to substantially all medical and surgical benefits covered by the plan;

Mental health and substance abuse benefits cannot be subject to separate cost sharing requirements;

Any treatment limitations applicable to such mental health or substance use disorder benefits can be no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan; and

There can be no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits.

A plan must provide out-of network coverage for mental health or substance use disorder benefits if the plan provides coverage for medical or surgical benefits provided by out-of network providers.
The financial parity requirements of the law do not apply if, after complying with the Act for a minimum of six months, an actuary determines and certifies that compliance with the new law results in an increase in the total costs of coverage (medical and surgical benefits and mental health and substance use disorder benefits) of more than 2% for the first plan year and 1% for each subsequent plan year. If the exemption is claimed, a notification must be sent to plan participants and beneficiaries, the Secretary of Health and Human Services, and appropriate state agencies.

In addition to financial parity provisions, the new law requires the plan administrator to disclose the criteria for medical necessity determinations and the reason for any denial of reimbursement or payment for services made under the plan with respect to mental health or substance use disorder benefits.

The new law is effective for plan years beginning on or after October 3, 2009 (January 1, 2010 for calendar year plans). For collectively bargained plans, the law applies to plan years beginning on or after the later of January 1, 2009 or the date on which the last of the collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after October 3, 2008).

Michelle's Law

Group health plans that extend coverage for dependents based on full-time student status must continue that coverage for one year (or until coverage would otherwise end for all dependents, regardless of student status, or earlier) if the dependent is on a medically necessary leave of absence from the educational institution. A medically necessary leave of absence is a leave of absence or other change in enrollment that (a) begins while the dependent is suffering from a severe illness or injury; (b) is certified by a physician as medically necessary; and (c) causes the dependent to lose student status under the terms of the group health plan.

When requesting certification of student status, a group health plan must describe the extension of coverage during a medical leave of absence. In addition, a summary of material modifications must be provided to plan participants describing the plan amendment that implements Michelle's Law.

Michelle's Law is effective for plan years beginning on or after October 9, 2009 (January 1, 2010 for calendar year plans).

How Does Your Benefits Plan Rank

Rankings reflect results of consumer surveys and success in preventing and treating illness compared with average health plan. The highest possible score is 100 points.
Listed are California only PLANS. This information was pulled from a national list of companies being ranked, and this list changes annually.

Rank Company Name Score Consumer Prevention Treatment
Assessment

#48 Kaiser N. Cal 85.3% 2 4 5

#100 Kaiser S. Cal 82.9% 3 3 4

#159 Western Health 81.3% 2 3 2

#172 Pacific Care Cal 80.5% 1 3 2

#184 Health Net Cal 80.1% 1 3 2

#189 Blue Shield Cal 79.7% 2 2 2

#198 Cigna Cal 78.8% 1 2 2

#212 Aetna Cal 76.3 1 1 2


Other helpful tools for picking a health plan:

Poring over health insurance alternatives, as millions of Americans will do this month and next, is nobody's notion of a fun time. But mulling over the various options is the only way to meet your needs without devastating your paycheck. These 10 tips will help you focus.

1. Weigh flexibility. The three main types of health plans differ in members' degree of personal choice in selecting caregivers. Someone with diabetes or another chronic condition may want a point-of-service (POS) plan or preferred provider organization (PPO), which offer unrestricted access to specialists. An HMO, which limits members to physicians in a defined network, might provide enough choice and protection for someone young and healthy.
2. Check the provider network. If physicians you use are not in the plan, switching to others will be a hassle—and if you chose them for their specific expertise, your health might even be affected.
3. Consider coupling catastrophic care with a special fund. You can cover the high deductibles in a catastrophic-care plan from a health reimbursement arrangement (HRA) set up and funded by your employer. Otherwise, you can pay the deductible from a tax-deductible health savings account you set up yourself.
4. Monitor the maximums. Most plans specify the out-of-pocket total, often thousands of dollars, that members must pay before full coverage kicks in. But employees in 20 percent of health plans are never fully covered, according to the Kaiser Family Foundation's 2008 Employer Health Benefits Survey. And copays usually don't count toward the maximum.
5. Check for caps. Many plans impose annual limits—on coverage for medications, for example, or the number of visits for physical therapy following an injury. A 2008 report by the Commonwealth Fund found that one fourth of insured adults face steep bills because of coverage limitations.
6. Review your medications. A brand-name drug for a chronic condition can be costly. The plan's list of medications, or formulary, will show your copay.
7. Get meds by mail. Many plans offer this convenient option, which often includes lower copays.8. Cut expenses with a tax-deductible FSA. Like HRAs, flexible savings accounts are set up by employers, but unlike HRAs, they are employee funded. Contributions are subtracted from pretax income.
9. Check out wellness management incentives. Many plans offer discounts if you take a health risk assessment, stop smoking, or keep your diabetes under control.
10. Use comparison tools. Ninety percent of employers provide online cost estimators for comparing plans, but only 9 percent of employees use them, says benefits consultant Hewitt Associates.

If your company stumbles, what happens to your health coverage?

For years, workers have watched their healthcare outlays rise and benefits shrink, and for some, whether they will have benefits at all suddenly is in doubt. As Wall Street's turmoil sloshes over Main Street, it seems that every day another trusted company files for bankruptcy, succumbs to a takeover, or shuts its doors. Nearly 34,000 businesses filed for bankruptcy in the 12 months ending in June, 42 percent more than the year before—and the word from on high is that this may be just the beginning. If your company stumbles, your healthcare, along with your job and your 401(k), could suffer as well. Many employees may worry they're only a couple of bad balance sheets away from joining the ranks of the nearly 46 million Americans without health insurance.

Costly COBRA. Extending coverage under COBRA, the federal law that gives employees who lose jobs the right to continue coverage under the company's health plan for up to 18 months. The law applies only to companies with 20 or more workers, but some states extend the option to workers from smaller companies such as in California with Cal Cobra.
Taking advantage of COBRA can be costly, however. Workers must pay the full premium—their former share and the former employer's share—plus a 2 percent fee. The monthly tab to cover may be far more than people can afford. There are programs which children can get for lower income households at no cost or minimal costs under Health Families Programs. For those who have little or no health issues, them may be eligible for an individual plan including less costly high deductible plans "Basically, if something catastrophic were to happen, they wouldn’t be bankrupted."

When companies shed workers, COBRA can cushion the blow. But with the average total premium for a family health insurance policy approaching $13,000 a year, many families, cannot afford the expense in their newly strained circumstances. Only about 27 percent of eligible workers elect COBRA coverage, according to a survey by Spencer's Benefits Reports. There is another option for two-earner couples: If one partner still has a job and is covered, the newly jobless spouse can join that plan under special enrollment rules that kick in following a bankruptcy or other "qualifying event."

Employees aren't always left so exposed when a company gets into financial trouble. Another company often takes over the ailing firm, as happened with Washington Mutual, Wachovia, and Merrill Lynch, which were acquired by other banks during the financial meltdown. Employees absorbed into the new firm may see no changes in their benefits, at least not initially. "The new employer may continue the existing program for a period of time." It may be a year or more before employees have to think about changes."

Stable Insurers. A comforting note amid the current economic wreckage is that healthcare insurance providers themselves are unlikely to go under. State regulators keep close tabs on these companies. They must submit quarterly financial statements and annual reports demonstrating sufficient reserves to cover claims. The standard in all states for "sufficient" requires that for every $100 in premiums collected, an insurer must have $250 in reserve. If a company's reserves drop below that level, regulators can effectively take over management of the company until its reserves are back in line.

Troubled insurers can—and occasionally do—become insolvent. If a company loses liquidity because of underperforming investments, for example, it might be unable to pay claims or continue operations, but in those relatively rare instances, claims are covered by a guaranty fund into which all insurers must pay.

In these uncertain times, that's one less thing to worry about.

Report compares candidates' healthcare proposals.

The Orlando Sentinel (10/2, Shelton) reported, "In a 63-page comparison, the nonpartisan Commonwealth Fund found that both" Sens. John McCain (R-Ariz.) and Barack Obama's (D-Ill.) healthcare "proposals lack specifics and each would cost more than $1 trillion during a 10-year period."
HealthDay (10/2) noted, however, that although "both presidential candidates want to make health insurance available to more Americans," The Commonwealth Fund's analysis favored Sen. Obama's plan, saying that it "shows greater potential for making care more affordable, accessible, efficient, and higher quality, though it will likely fall short of covering everyone." The report indicated that Sen. McCain's plan, on the other hand, "is likely to increase insurance administration costs" and that it "would not likely lead to universal coverage" either.
Modern Healthcare (10/3, Blesch) adds that one of the Commonwealth Fund's top "criteria for judging the proposals" was whether they "advocate universal coverage as a goal." The report contended that Sen. Obama's plan would "provide more people with affordable health insurance that covers essential services, achieve greater equity in access to care, realize efficiencies and cost savings in the provision of coverage and delivery of care, and redirect incentives to improve quality." Meanwhile, because Sen. McCain's plan "focuses on making it easier for people to buy insurance on the individual market if they don't get it at work, providing tax credits, and allowing policies to be purchased across state lines," The Commonwealth Fund was "critical of [his] strategy." The report indicated that Sen. McCain's plan may result in less employer-sponsored coverage, "and that insurance deregulation might encourage insurance companies to compete on price but also neutralize consumer protections."
"Robert Moffit, Ph.D., who directs the Center for Health Policy Studies for the conservative think tank Heritage Foundation, called the projections 'nonsense,'" WebMD (10/2, Boyles) noted. Moffit, "criticizing the report's projections of uninsured people," said that "he's not surprised by the report's conclusion, since the Obama plan is very similar to one proposed by The Commonwealth Fund earlier this year." He also faulted "the report for concluding that McCain's proposed tax changes will only have limited effects on boosting the number of insured Americans." Moffit argued that because the country has "never had a tax policy like" Sen. McCain's in the past, "there is no historical experience to draw from." And, he found it "hard to believe that" Sen. McCain's "generous tax relief, including refundable tax credits...will only result in two million more insured."
With regard to the candidates' focus on health IT, the report indicated that "greater adoption of health information technology could save the country" an estimated "$88 billion in a 10-year period," according to Government Health IT (10/2, Robinson). The report, however, "assumes a one percent assessment imposed on insurance premiums and Medicare outlays -- money the federal government would then provide to state and local agencies to accelerate the adoption of health IT." And, although the report "states that about $368 billion in savings could [be] realized by establishing a center for medical effectiveness," Government Health IT noted that neither candidates' "proposals have offered many details about their health IT plans."

Request a copy of "What really ails the U.S. health care system" (FACT or FICTION). email request with title of book, and your name, address, and phone number to:
info@amsinsure.com .

Small Firms More Likely To Offer 100% Employer-Paid Health Care Coverage

From Spencer's Benefits Reports: In 2005, 23.4% of employees in firms offering health insurance had access to at least one plan where no employee contribution for the health insurance premium was required for individual coverage, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). In the statistical brief, the AHRQ presents estimates of offer rates and enrollment in employer-sponsored health insurance plans requiring no employee contribution in the ten most populous states in 2005. “The availability of such plans varies considerably by state and firm size, among other factors,” the AHRQ noted. The brief also reviewed state variations from the national average.The great majority (86.9%) of the 112.2 million private sector employees in the United States in 2005 worked at firms that offered employer-sponsored health insurance, the AHRQ said. Among the ten most populous states, California had the highest percentage (37.1%) of workers whose employer offered at least one health care plan for which an employee premium was not required for individual coverage, and the largest proportion of employees (36.1%) with individual coverage who were covered by such plans. Florida and Ohio had the lowest proportion of such covered workers (18% and 16.7%, respectively).Workers at small firms that offered group health insurance were most likely (49.4%) to have available premium-free individual coverage in 2005. Furthermore, such employees were much more likely than those in large firms to be enrolled in a plan that required no premium contribution for individual coverage. More than half of individuals enrolled in an employee-only plan in small firms had no required employee premium contribution; this also was true for more than one-third of those with family coverage in small firms. Workers for small firms in New York who were enrolled in employer-sponsored family coverage were most likely (55.1%) to have such coverage premium-free.Overall, 11.9% of workers in firms that offered health insurance were offered at least one family coverage plan that required no employee contribution. In California, Michigan, New Jersey, and New York, a higher than average percentage of workers in small firms were offered health insurance and had access to at least one plan with no required employee contribution for family coverage; while in Florida the same percentage of workers was lower than the national average.Among large employers, the national average for coverage in premium-free employee-only plans was 14.4%; the national average for family coverage was 9.1%. California (26.9%) New York (14.6%) and Michigan (15.5%) had higher than average individual rates. California (15.5%), Michigan (13.0%), New York (10.0%), and Pennsylvania (12.4%) had higher than average family rates.State Differences in Offer Rates and Enrollment in Employer-Sponsored Health Insurance Plans that Required No Employee Contribution to the Premium Cost, 2005, Statistical Brief #213, Medical Expenditure Panel Survey (MEPS), issued in July 2008.

What really ails the U.S. heatlh care system

Right now, the United States is undergoing a national debate about how best to deliver health care to her people. The lives of our most vulnerable-aging citizens, those with chronic illness, tiny babes-are at stake. Our future financial strength and ability to make personal decisions about our own lives, likewise, lie at the center of this critical debate.



Be informed and request your copy of (What really ails the U.S. health care system) now, email us at info@amsinsure.com and put the title in the subject line and your address in the body of of the email. We will be happy to send you a copy free of charge. We want everyone to be knowledgeable and be able to add in to this great debate with competent knowledge.

Othere topics in the book: facts, not fiction;

• The Common Myths, Misconceptions, & Deceptions



• Cost of Health Care Administration



• Quality Measurements of U.S. Health Care: Infant Mortality and Life Expectancy



• The Uninsured "Crisis"



• The Cost of Health Care and Health Insurance



• Defining Terms



• What are the Facts about Government-run Mandatory Universal Health Care



• Why the U.S. has Avoided Mandatory Universal Health Coverage



• Where & How Did We go Wrong



• The Key Issue



• Patients as Consumers



• Curing What Ails U.S. Health Care

Its informative, filled with factual information and most important easy to read and uncomplicated.

Once again; info@amsinsure.com






310-534-8071

Controversial Medical Billing Practices by the medical profession

Controversial billing practice may account for $1 billion in medical fees paid by patients.
BusinessWeek (8/29, Terhune) reports, "As healthcare costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe" due to a common, yet often illegal practice known as balance billing. When this happens, "an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid," and the provider "demands the balance from the patient." BusinessWeek notes that "state and federal laws generally bar the medical providers from pressuring patients to pay the difference." Yet, as this practice continues, "economists and patient advocates estimate that consumers pay $1 billion or more a year for which they're not responsible." In fact, in California alone, an estimated "1.76 million policyholders...received such bills in the past two years, totaling $528 million," and 56 percent paid.

Typically, patients fall victim to balance billing when "medical providers participating in a managed-care network believe the plan's insurer is imposing too deep a discount on medical bills or is taking too long to pay." Currently, 47 states "ban in-network providers from billing insured patients beyond co-payments or co-insurance required by the plan," and "federal law prohibits providers from billing Medicare patients for unpaid balances." Yet, "regulators in most states have been slow to take action in billing disputes."

Industry experts say small business owners can make use of summer downtime.

The last few weeks of summer can be a useful time for small business owners whose companies are going through a slow period -- they have a chance to tackle some of those tasks they've been putting off. While some owners use summer downtime for big projects like writing an employee handbook, other owners cross off more mundane items from their to-do lists, such as entering that pile of receipts into their accounting software. Summer is a good time to get all this stuff done, in preparation for the fall. ... A mistake so many business people make is they wait until Sept. 1 to really gear up. They're really short-shrifting themselves. In planning downtime projects, owners may want to consider what changes...to make to their products or services, or how to adjust their marketing programs. Other experts recommend making changes to websites, examining costs and seeing what...can be cut, and thinking about employee issues.

Aging U.S. population visiting hospitals more, study shows.

There are reports that the "aging of the U.S. population is translating into many more visits to doctors' offices and hospitals, a reality that is taxing weak spots in the healthcare system, according to a government report released Wednesday." Investigators found that overall, "[p]eople made an average of four visits a year to doctors' offices, emergency rooms, and hospital outpatient departments in 2006, a total of 1.1 billion visits." The data also showed that the "number of medical visits increased 26 percent between 1996 and 2006, significantly higher than the 11 percent population growth during that period."

The national Centers for Disease Control and Prevention (CDC) in Atlanta released the statistics, and they came "from various components of [the] CDC's National Center for Health Statistics National Health Care Survey".

According to the CDC, "the observed increase in medical visits 'can be linked to both the aging of the population, as older persons have higher visit rates than younger persons in general, and an increase in utilization by older persons.'" In terms of racial disparities, the "overall visit rate was not significantly different for white and black persons." But, "African-Americans had higher visit rates than whites to hospital outpatient departments and emergency departments, and lower visit rates to office-based surgical and medical specialists." Additionally, "[r]egardless of setting -- physician office, outpatient clinic, or emergency department -- seven out of 10 patients left the medical visit with at least one prescription, and analgesics were the most common drug prescribed."

Medicare Supplements - Click for rates if you are 65+

At Home Employees doing Company work

Here's a question you may not have thought about: If one of your employee's is working at home and is injured, are you responsible? The answer depends on individual circumstances. For example, electrocution from a faulty cord on a computer you provided is different from a slip and fall on the way to the bathroom. As technology allows more and more work to be performed at home, it's a good idea to adopt safety expectations for your employees' home offices.
Here are some ideas to keep in mind if you have staff working from home:

* Temperature, noise, ventilation and lighting levels should be adequate.
* Electrical equipment should be free from hazards (e.g., frayed or exposed wires). Wiring and electrical cords should be secured and out of the way.
* The work area should be large enough to safely accommodate all equipment, wiring and so on without posing a risk of hazard to the employee.
* Hallways and doorways should be free from obstructions.
* The working environment should be free from clutter or materials that could create fire hazards.
* Floor surfaces should be clean and dry. Carpeting should be properly secured.
* There should be ample lighting for the work that the employee will be doing.
* The working area should be equipped with sufficient electrical outlets to accommodate all necessary equipment safely.
* Desks and chairs should be the appropriate size, height, etc., to provide comfort.
* Some organizations ask employees to sign a statement indicating that they will comply with the company's stated safety requirements; others even ask employees to bring in photos of their work areas indicating that they are in compliance with safety regulations.

Employee safety needs to be your concern even when their working from home.
If you or someone you know has staff that telecommutes or works from home contact your Business Insurance agent or we can offer references to you. For more HR updates ask us about our HR platform offered free to AMS clients. 800-334-7875

AMS Clients receive HR as a client benefit

Information which will help you to manage your business keeps you updated and ready. Sharpening Your Screening Interviews is a current article from our HR Affiliate.

Many employers adopt some sort of interview process. Unfortunately, many employers also abbreviate the process by hastily moving from the resume review stage right into the hiring interview stage. In between those two stages, however, the prudent employer will conduct screening interviews to separate the truly qualified job candidates from the unqualified candidates.There are four basic tips to help managers make the screening interview stage an integral part of a successful employee selection process:

Know Your Business Needs. Before placing that ad or starting the search, you hopefully already developed a job description that defines what your business needs are. The job description should be specific about the job duties, the necessary skills set, the type of required experience / education, and any other information to help you identity the ideal job candidate.

Review the Resume. Get familiar with the candidate’s resume before the phone or in-person screening interview. Make a checklist of standard questions to ask each candidate and any notes specific to the resume in question. Have all this information with you to briefly look over just before the interview to help confirm your mental map for the discussion.

Figure Out the Fit. During the screening interview, exercise sound judgment in assessing the candidate’s personality traits. Pay attention to the candidate’s overall attitude, behavior, and knowledge toward the company and any employees the candidate may have met already. For example, how well does the candidate respond during the interview?

Watch the Warnings. With the resume at hand, be sure to verify statements made on the resume, and isolate any apparently exaggerated or seemingly falsified information. For example, how the candidate phrased his or her familiarity of certain computer office programs on the resume may be questionable. In turn, ask the candidate to provide a concrete example.

By verifying the integrity of each candidate’s resume through the screening interview process, you will gain a clearer perspective of the how to better define your pool of truly qualified candidates towards selecting your next great employee.

Not Understanding At-Will Employment Puts Your Business at Risk

"At-will" employment refers to a common-law rule that the employment relationship may be terminated by the employer or the employee at any time, for any reason, with or without cause or notice. For employers, the ability to terminate an employee whenever they want and for whatever reason is invaluable. This perception, however, is not quite accurate. Over time, the establishment of various federal and state regulations and the application of certain employment law concepts have created conditions and layers much more in favor of today's employee. To minimize the risks of wrongful termination claims, every employer needs to understand at least the three big exceptions to the employment at-will concept:

Public Policy: A wrongful discharge when the reason for employment termination is contrary to an established state public policy (i.e. terminating a pregnant employee protected under the federal Family Medical Leave Act).

Implied Contract: A contract between the employer and the employee although no written documentation exists regarding the employment relationship (i.e. “Probationary Period” language in the Employee Handbook).

Covenant of Good Faith: An implied agreement the employer is to treat employees honestly and fairly (i.e. A “just cause” standard placing a burden of proof on the employer to justify the basis for discipline or discharge of an employee.)

Tool of the Month: HR Checklists

Whether faced with a hiring, performance management, or employment termination issue, the manager needs to make sure certain steps are covered. To help keep track, you may review and download various HR Checklists developed by HR professionals.To learn more about the HR Checklists, become a client of AMS and receive free HR support.

Are Regular Old 401(K)s Better Than Roth 401(K)s?

Conventional wisdom touts Roth 401(k) plans as the better choice for most taxpayers over regular 401(k) plans. But a paper in the July 2008 issue of the Journal of Financial Planning, published monthly by the Financial Planning Assn. (FPA), argues that not only are regular 401(k) accounts superior to Roth 401(k)s for all but the wealthiest of taxpayers, but they’ll also remain superior even if future tax rates rise.

The conventional wisdom is that, if a retiree’s tax rate is the same as the tax rate when they were contributing to a 401(k), it shouldn’t make any difference whether that person puts money into a regular 401(k), whose contributions are tax-deferred or a Roth 401(k), whose contributions are made with after-tax dollars. The retiree will end up with the same amount of after-tax money way.However, side fund analyses argue that it isn’t an apples-to-apples comparison. For example, an affluent taxpayer putting the maximum $41,000 into a 401(k) would actually need $56,944 in order to fund the Roth. That’s because the taxpayer would need to pay $15,944 in taxes on the $56,944 (at a 28% tax rate) in order to have $41,000 left to fund the Roth. A taxpayer using a traditional 401(k) would need only $41,000, as it’s not taxed upfront.

To make the comparison fair, side fund analyses create a taxable side account for the regular 401(k) contributor and fund it with an amount equal to the extra amount needed to fund the Roth 401(k)—in McQuarrie’s example, $15,944. They then compare the after-tax results, and the Roth version wins. McQuarrie illustrates that the supposed superiority of these analyses is flawed because so much depends on analysis assumptions such as the taxpayer’s age and asset allocation.But the more important argument McQuarrie makes for the superiority of the regular 401(k) is the difference between marginal and effective tax rates. Let’s say a taxpayer is in the 28% marginal tax bracket. That is, all or most of that taxpayer’s deferred contributions to a regular 401(k) account would probably have been taxed at that 28% rate if not contributed to the 401(k). That saves the taxpayer money upfront, but of course they have to pay taxes on the contributions and their earnings, when withdrawing funds during retirement. But that person doesn’t pay the 28% tax rate on every withdrawal dollar.

Under our progressive tax system, the first dollars of taxable income are assessed at the lowest tax rate (10%), then the next chunk of income is taxed at the next higher rate, and so on until the last chunk of dollars is taxed at the taxpayer’s highest rate. The result is an effective or average rate for the taxable income that’s lower than the top marginal rate. In McQuarrie’s example, the effective rate is 19.4%, not 28%. Workers using regular 401(k)s are deferring taxes at their marginal rate, but paying taxes at their lower effective rate when they withdraw the money during their retirement years, making them a superior choice for most taxpayers. McQuarrie also demonstrates that, the effective tax rates are likely to remain lower than the marginal rates for most taxpayers even if Congress increases future tax rates, leaving the regular 401(k) still the better choice.

For more information, visit: http://www.quotit.net/ams/pension.htm


Check the difference of: Taxable vs. tax-advantaged saving comparison

401(k)s Are More Important Than Ever

Employees who contribute to their 401(k) plan and who are willing to make small improvements to their saving and investing habits can increase their future income potential, according to a study by Hewitt Associates. When factoring in inflation and increases in medical costs, Hewitt predicts that employees will need to replace, on average, 126% of their final pay at retirement. That is significantly more than the traditional targets of 70% to 90% pay replacement.The Hewitt’s study examined the projected retirement levels of nearly 2 million employees at 72 large U.S. companies using actual employee balances and behaviors. Only 19% will be able to meet 100% of their estimated needs in retirement. On average, employees are projected to replace just 85% of their income in retirement, compared to the 126% they need. In other words, assuming inflation of 3% and a retirement age of 65, an average 40 year old with 10 years of service and earning $83,000 at retirement in today’s dollars would have saved enough to provide just $70,500 per year in retirement in today’s dollars -- a $34,000 annual shortfall. In fact, 67% of employees are expected to have less than 80% of their projected needs at retirement.The scenario is even more serious for employees who do not contribute to their 401(k) plans. Employees who contribute an average of 8% of pay to their 401(k) plan can replace 96% of their preretirement income at age 65, providing about 80% of what is needed to provide the same standard of living during retirement. That number drops to just 54% for employees who do not contribute, which equates to less than 40% of projected needs. Even employees who have a pension plan can expect to replace just 62% of their income at retirement if they do not contribute to their 401(k) plan, compared to 106% for those who do contribute. Recent Hewitt research shows that 26% of employees do not participate in their 401(k) plan, and of those that do, 61% contribute less than 7% a year. Hewitt’s study found that employer-subsidized retiree medical coverage has a dramatic affect on an employee’s ability to achieve adequate retirement savings. The good news is that people can take small actions in several areas and make a big difference. Gradual increases in savings rates, smarter investing, lower fees and delaying retirement can have a significant affect and enable most people to achieve a much more comfortable standard of living once they retire.

For more information, visit http://www.quotit.net/ams/pension.htm

Limited Benefit Plans lower employer costs!

Many small businesses today are struggling to stay ahead in an economy which is causing higher costs of doing business and offering less opportunities to grow business or just maintain business levels. While it makes sense to offer benefits, these small businesses must cut costs and one way to do it is to offer limited benefit plans.

Many companies today have these choices available so it pays to take a look and see how these plans can be used by the employer to continue to offer benefits and make it affordable with a need to trim business costs. In addition to these limited benefit plans most companies will offer a menu of plans which would allow the employee who wants a richer benefit to buy up and have a payroll deduction for the additioanl cost and where there is a section 125 plan inforce receive the benefit of lower costs with pre tax payroll deduction prior to the taxes being taken out.

The employer can also receive a payroll savings helping to lower there costs by 7.6% with this savings. By making these choices the employer will miantain employee loyality with providing benefits and be competitive in the job market.

You can also find these types of plans at http://www.amsinsure.com; http://www.bchealthplans.ws and http://www.kaiserhealthplans.ws.

For more information on how to save benefit dollars contact us at 800-334-7875.

California governor calls for state healthcare reforms.

California Gov. Arnold Schwarzenegger (R) called for reforms to address the woes of the uninsured and healthcare inflation at the Catholic Health Association's yearly meeting. The governor's "$14.4 billion plan to overhaul healthcare in California cleared the state's Assembly in December, but died in the Senate Health Committee the following month." He said that "without action, the [healthcare] situation...will only worsen."

Claims that technology can help fix health care system and low costs.

Healthcare stakeholders should welcome disruption as an opportunity to advance the industry, and "technology is the disruptive innovation that can help fix the broken healthcare system," said Clayton Christensen, author and Harvard Business School Professor, Friday at the America's Health Insurance Plans conference. He claimed that technology could "make healthcare affordable for those who cannot pay for healthcare services." Christensen pointed to "three specific technologies" to implement his ideas: "molecular diagnostics to understand genetic structure, imaging technologies to look inside the body, and high-bandwidth telecommunications to bring expertise to offices with limited healthcare resources." If his "views are borne out, integrated caregivers, such as Kaiser Permanente,...will have a significant advantage over other stakeholders, he said."

Link

Life Expectancy continues to rise in the U.S..

It has been reported in several publications that the life expectancy continues to rise with the disperity amongest various groups becoming less than in previouse reports. While the age has risen to 78.1 and this is only 29th among all nations in the world where the average is 83 years. You can refer to national publications for additional information and check your personal life expectancy with our The Living to 100 Life Expectancy Calculator© is brought to you by Dr. Thomas Perls in partnership with the Alliance for Aging Research, a not-for-profit organization based in Washington, D.C. The Living to 100 Quiz was designed to translate longevity research of centenarians into a practical and empowering tool for individuals to estimate their longevity potential.

The Five Steps of Effective Employee Coaching

In the AMSINSURE monthly newsletter HR Advisor June 2008 addition from HRANSWERLINK.

New employee orientation and job-specific training serve important purposes. Coaching, however, is a critical key that is set aside unfortunately once too often. A business owner may think that spending the time to coach is too difficult, but it is his or her leadership that helps create a great team of inspired, productive, and loyal employees.
Employee coaching involves the managers and employees meeting regularly to discuss and explore each employee's career goals and development. There are five basic steps in facilitating employees to become high-performers in your team. Discuss the employee’s expectations of the job. Whenever a new employee is hired or an employee’s job functions change over time, always address any questions or confusion the individual may have about the job. To help confirm or clarify the employee’s perspective of the job expectations, review together a copy of the job description, department’s goals, and company’s goals.

Understand the employee’s expectations of the manager. While different employees have different communication styles, learn about what each employee expects from you as a manager and come to a reasonable working agreement.

Learn about the employee’s expectations for professional growth. Some employees work for just the paycheck, and some have specific professional development interests and ambitions. Recognizing and gathering relevant resources to help support and build a plan for each individual’s interests help strengthen employee loyalty.

Give feedback about the employee’s performance. Consistent and constructive feedback becomes effective when focused on raising awareness and on improving performance results.
Get feedback about your performance. You are a manager as well as a member of a team. How well you respond to feedback from your teammates will make a significant influence on your team’s synergy and success.

Each employee should come out of every formal and informal coaching meeting with a strong picture of both the specific performance goals to achieve and how his or her contributions impact the department and the company as a whole

Universal Life showing strong growth

A recent report by LIMRA, an industry association with over 850 financial services companies in more than 70 countries around the world turn to LIMRA first to help them build their businesses and improve their performance. In the study it was found that more people are turning to the purchase of Universal Life as sales where up 8% in a recent industry survey.

Other products a decrease in growth including term life which dropped 3%. It seems that the lower premiums of a permanent product like Universal Life can be delivered for less cost and maintain increasing value with long term stability. The average variable universal life policy bought during the first quarter of 2008 was 7% larger than those purchased in the same period of 2007.

Considering life insurance for your business or family then this might offer a solution.

John Beyer
jbeyer@amsinsure.com

Considering a Corporate Wellness Programs

Corporate wellness programs can enhance employee health and productivity. They can also help curb the rising cost of health care benefits. Corporate wellness initiatives are gaining momentum, but they can potentially backfire on employers if they are not designed and implemented properly. To avoid negative consequences, employers must understand the legal aspects of their wellness programs to ensure they comply with a myriad of federal and state regulations. When considering these programs it would be appropriate to review the various HR considerations to be compliant.

"The legal implications of wellness initiatives are far reaching, and designing programs that are compliant with current law can be challenging." "There is a lack of legal precedence in this area, which means there isn’t much to guide employers as they navigate this uncharted territory. But compliance is critical, so employers must be sure they understand and consider compliance issues as part of their program development process."

Its important for employers to be mindful as they plan their wellness offerings to ensure every worker has a chance to benefit from each program available. For example, if a walking program is developed, the employer needs to think about accommodations necessary to include those who use a wheelchair or require some other form of assistance. The key is to provide flexibility and elasticity in all programs so that everyone can participate."

For small employers considering these programs they can use those offered by there health carrier or other commercial programs in the community.

As an owner, should I consider a group LTD (Long Term Disability Policy) or an LTC (Long Term Care Policy).

With the lowest rates currently avaialable on these policies with high limits, no medical exams, and even guaranteed issue it may be time to consider as these plans are one of the lowest cost benefits offered to employer groups. The costs can even be shared with the employee, however with these low cost it makes good sense as a benefit.

Group plans me be offered along with voluntary plans that can add value since the group becomes a base and then the voluntary individual plans will cost less as the employee only needs to supplement a smaller portion of there risk.

What are some of the other benefits of these plans. Employees become more secure knowing they have income if the are sick or hurt and thereby are less likely to leave an employer saving turnover costs and return to work faster with a secure income that assist them with recover by relieving tension form that would have been there from financial stress. LTC policies have the same value with a low cost employer base plan allowing the employee to supplement an invidual policy at less expense to them. Another advantage is they can add not only a spouse, but parents, enlaws and others to a supplemental group plan even though they are not on the base group plan.

For more information: email, jbeyer@amsinsure.com or call 800-334-7875

click on the links below for more information:

Disability Income Plans…Often overlooked building a strong financial plan; this type of policy provides the base of all future plans. Consider the odds of every other risk in life and this one is ahead of them all. Take a moment to consider the possible problems for short term or long-term loss of income from an accident or illness. In a few minuets you can decide on whether you should get a proposal, it only takes a moment. Whether you work for a company, are self-employed or a business owner, there is a plan for you.

Long Term Care…(LTC) is a phrase, which is used to describe a variety of services in the area of health, personal care and social needs of a person who requires assistance with the basics of living. Services can be provided in home care, assisted living, or a convalescent care facility. Recent studies based on nursing home admissions indicate that 40% of all persons age 65 and over will enter a nursing home in the future.

Californians Get on the Web

More Californians are using the Internet than in 2004, especially to locate information about their insurance plan. In 2007, 56% of survey respondents went online to find information about medical conditions or prescription drugs. But only13% of them made provider appointments online and only 12% filled prescriptions online, according to a survey by the California HealthCare Foundation. Only 26% of the Internet users sought rating information on healthcare professionals. Twenty-three percent of respondents viewed online hospital ratings information in 2007. But only 1% actually made a change in their healthcare decisions based on the ratings. For more information, 800-334-7875 infor@amsinsure.com or go onlin at http://www.amsinsure.com/

How is Small Business doing in 2008

As a benefits agency working with small business we are keenly interested and aware of some of the problems facing business owners. If it is an established business or a new business the problems may be the same.

With personal foreclosures on real property and bankruptcy fillings growing it is not news that small business bankruptcies are also on the rise. There has been a 49% increase over last year with an average of 235 daily fillings in recent months according to the latest reports.

As a small business owner you may not be surprised to hear this with tight credit and rising cost squeezing the bottom line.

What can be done to work through these though times and get to the good times we all want to see arrive as soon as possible.

1) If you rely on credit in your business, banks are not going to make it easier even with all the fed interest rate cuts and may want some incentive to provide loan capitol.

2) Evaluating all the costs and revenue sources may help to keep things in line, including holding off on some expansion plans, and not adding new staff. In fact you may have to consider cutting back on staff. One consideration would be to increase the productivity of staff by offering incentives and benefits, which while adding some level of cost may in fact produce more revenue

3) Looking for value added services from your vendors which can enhance your operations without adding costs. Cutting benefit costs with lower cost plans and maintain contributions levels that are affordable.

4) It would be helpful to see both the federal and state governments provide some tax incentives and tax relief which while aiding the small business, which would lead to a strong economic picture and ultimately a broader tax base in the future.

As benefit consultants we can help you to reduce costs and add value through services like are HR and Payroll platforms.

Business Edge Newsletter current issue here
Recruiting: Staying One Step Ahead of the Competition

www.amsinsure.com
info@amsinsure.com
800-334-7875

State Poised to Crack Down on Discount Health Plans

Cindy Ehnes, director of the state Department of Managed Healthcare, wrote an article in Capitol Weekly describing how the state will be cracking down on fraudulent discount health plans. The state will be proposing new regulations to license companies, imposing strict consumer protections for those wishing to operate in California. The department issued an alert, warning Californians of deceptive discount health plans and suggesting questions to ask. In 2007, the DMHC received more than 200 consumer complaints about discount health plans, almost one third of which were because the consumer believed the discount plan to be insurance. “In the past month, we have seen a substantial increase in the number of complaints regarding discount plans, so it would appear that some fraudulent companies may once again be marketing heavily in California,” she said.

The alert is available in English and Spanish at (click on the title above).

HR Services as a value added client benefit!

Today the demand for real-time HR problem identification and resolution is a paramount concern for all successful enterprises, regardless of size. Owners
and managers of small and mid-sized businesses need this information as critically as their big business counterparts. Unfortunately, until now, these executives could not get the needed information without hours of research or without paying an attorney.

AMSINSURE.COM through its affiliated partner offers to meet the needs of such organizations for low-cost access to HR information, resources and personalized assistance.

AMSINSURE.COM through its affiliated partner places HR information, tools and experience at the fingertips of the owners and managers of small businesses. Because we leverage the power of the Internet to deliver HR solution and services directly to the desktop, clients enjoy maximum flexibility and convenience as a valued added service of AMSINSURE.COM and may add additional upgrade service over the basic service provided.

OUR MISSION
Bring required HR information, resources and professional assistance to the millions of small business owners and managers who need it. Present this information in a format that will be easy to access and to understand. Be there for our clients whether on the web or on the phone, not just as a reference but as a personal consultant who can help solve problems. Treat EVERY client with respect and make each one feel like he or she is our only client. Do all this at a subscription price any small business can afford.

OUR COMMITMENT
Our commitment is to provide high-quality HR resources, products and services to help you do your job. All you need to do is access these resources.
Ask how we can provide these services to your company.

info@amsinsure.com
800-334-7875

California Lawmakers Take a Stab at Legislating Healthy Habits

AMS Favorite Links…Value added services

Last week, an Assembly committee in California approved a bill that would require companies bidding on California state contracts to provide wellness benefits for employees. It's not a big part of anybody's health reform package, and the odds aren't good that AB 2360 will become law, but the attempt represents a significant shift in thinking about health care and how it can be legislated.Many states and employer groups, both public and private are starting to recognize that to truly achieve better results in health care including expenses is to do something to help encourage a healthier life style.
Many state legislatures now have or are working on legislation to help bring about more awareness and promotion of healthier life styles as a part of providing for health care programs that don’t just pay the bills for problems or cures."So much of Western medicine is geared to reacting when something goes wrong that we don't pay a lot of attention to staying away from trouble.
A generation ago, attempts to legislate wellness and healthy habits were unheard of. They're still rare now, but less so. Today there has been a noticeable increase in the number of bills promoting wellness programs in state legislatures.Bills have taken different approaches to encourage wellness programs, including insurance premium discounts or rebates for participation in wellness programs, discounts in group premium rates and tax credits.When one looks at the results of healthier life styles and the effect it has on individuals and groups, the results clearly show that future costs of health care can be dramatically affected if the percentage of people improving there life style through healthier habits grows.
Look to see more legislation, employer involvement in healthier lifestyle programs including incentives to help encourage people to participate and manage there life style programs.
Does your health plan or company benefit carrier have programs, check it out as most do and have for the last several years. As an employer or employee consider the many opportunities available.
Commercially you can sponsor programs from some of the top fitness, weight management, and health care testing companies in your own community.
Need some assistance with this, contact us and will consult with you on how to develop and encourage the use of these plans with your companies employees.

800-334-7875

info@amsinsure.com

Reducing Employer and Employee Health Plan Expenses

Johnson and Johnson recently introduced a health care plan to most of its employees replacing a POS plan with an HRA (Health Reimbursement Plan). It is a special plan design and administrated by three insurance carriers. As a leader in the health care field this is again showing how a major company can introduce a plan which educates employees and gives them choice which are based on developing consumer awarness of medical cost and an opportunity to help reduce those costs.

'This is a major change "It's a whole new way for [employees] to think about the delivery of health services." In January, J&J replaced the point-of-service plan it had offered for the past 10 years to its 43,000 white-collar workers in the U.S., mainly located in New Jersey, Pennsylvania, Florida and California. Under the old plan, employees were responsible for a flat $15 copayment for physician office visits.

All of the other health benefit programs were eliminated by J&J, although employees in some parts of the country have the option of enrolling in an HMO. Sexton says that about 70% of the company's entire work force is enrolled in the new account-based plan. To ease the transition toward the new plan, J&J relied on a technique used to market its products to the public — brand extension. Since the company's health and wellness program is known as Healthy People, the new health plan is called Healthy People HRA — folding it into an already recognized entity.

Small employers can also avail themselves of these plans and offer them as an option to standard plans. One way of doing this is through employer contributions and incentives. Employees who become more aware of health maintance programs and develope an awarance of provider cost to help reduce eventual claims expense can achieve savings for both themselves and their employer.

As more and more larger companies develope HRA and HSA programs so smaller employer groups will follow suit as they see the opportunity to better provide benefits and control costs.

Preventing Health Issues and Advocating Healthy Life Styles

The first step in understanding how prevention affects health care costs is to define exactly what is meant by "prevention." Its broadest definition includes anything that prevents disease, including healthy lifestyle habits and programs that usually fall under the "wellness" umbrella. Its narrowest definition is preventive care such as screenings for various types of cancer and other health risks.

Ideally, a health benefits program should include both clinical screenings and healthy lifestyle programs. Over the past several decades, the focus has shifted toward providing more preventive care benefits, but a stronger focus on preventing disease is still needed.

Preventive care in the United States
Prevention takes many forms: vaccines that prevent disease completely; medications that reduce the risk of developing disease; screening tests that detect disease at an early stage when treatment is more effective; and lifestyle changes - smoking cessation, exercise, diet - that keep people healthy longer.

Through a combination of public education and the growth of managed care, the use and coverage of many preventive care strategies has become more common. But preventive health care statistics in the United States still fall short of expectations. For example:
An estimated 30 percent of the more than 20 million Americans with diabetes remain undiagnosed.

The lifetime risk of developing hypertension is approximately 90 percent for adults between the ages of 55 and 65, but one-third of those affected don't know they have it. Americans receive appropriate preventive, short-term and long-term health care as recommended by professional guidelines only about 55 percent of the time. Approximately 45 percent of the U.S. population has a chronic medical condition, and about half (60 million people) have multiple chronic conditions.

Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually - nearly 40 percent of total yearly mortality in the United States. One reason why the use of preventive care is not as high as it should be is the large number of uninsured.People without health insurance are much less likely to receive recommended preventive services and medications or have access to regular care by a doctor than those who are insured. But simply having health insurance isn't the solution - it's important to have a plan that encourages the use of preventive care. In one study, screening rates dropped 5.5 percent in insurance plans that introduced cost sharing during the study period, yet increased by 3.4 percent in plans that maintained full coverage.5 By reducing or eliminating cost-sharing in health plans, plan sponsors can increase the use of key preventive services such as adult immunizations and tobacco cessation programs.

Another is lack of education. People often don't consider themselves to be at risk, don't know what preventive services they should receive based on their age, gender and risk factors, or are unsure about their effectiveness.7 It took a concerted effort by doctors, parents, government agencies, health insurers, employers and advocacy groups to achieve higher vaccination rates for children.

Saving lives and money with preventive care.
While immediate costs may be higher in some cases, preventive care can provide significant savings in both short- and long-term health-related costs. Preventable illness and chronic disease are major causes of employee absenteeism and presenteeism (decreased on-the-job effectiveness), causing a financial drain on businesses. A recent study found that increasing the use of just 5 clinical services to 90 percent of the target population would prevent 113,000 premature deaths each year. At least half of the deaths from cancers could be prevented by greater use of established screening tests and existing knowledge. Chronic conditions account for 70 percent of all deaths in the United States and the costs associated with them account for more than 60 percent of national medical care costs.

Studies indicate that prevention, early detection and chronic disease management would reduce the economic impact of disease by 27 percent, or $1.1 trillion annually by 2023 and the number of cases of chronic disease by 40 million. Flu vaccination reduced absenteeism by as much as 45 percent. Based on these numbers, you would expect that most plan sponsors would include coverage for preventive care in their health benefits plans. Unfortunately, that's not the case.

One study found that:
Only 57 percent of employers covered the flu vaccine. Less than 25 percent offered any kind of smoking cessation program. Colorectal cancer screening is offered by just over 70 percent of employers. Cost is the primary reason cited by plan sponsors for not providing more comprehensive health benefits that include preventive care. But some employers are beginning to realize that they can reduce absenteeism and presenteeism by investing in a healthy, productive workforce.2 In your role as a consultant, you can help your clients decide which preventive care services and programs will be most beneficial to their employee population.

Consumerism is also helping to increase the use of preventive care services. As consumers assume greater financial responsibility for their health care and become more informed about their risks, they're more likely to demand additional tests and procedures to protect their health.

Ask about the many Insurance Company special programs and benefits to help maintain health, healthy life styles and screenings for early detection of health issues. Contact, info@amsinsure.com or call 800-334-7875 or you can go online at http://www.amsinsure.com/ .

What can be the most agonizinag decission with Seniors?

Ask anyone with an older parent who is suffering from Alzheimer's, Physical limitations or just needs more care or around the clock assistance. When it comes to a parent or loved one we can agonize over so many thoughts; aside from economics there are many guilt producing barriers to arriving at the best decision. What that decision is can obviously be different for many, however the person most affected and may be better off with proper care in a day care setting, or home setting or perhaps senior care facility. Who is most affected, it is generally agreed by most professionals that the patient is the one whom needs to be considered. For the person making care decision, usually a close relative, they must put there feelings aside to assure that the person needing care receives the most appropriate care.

Where can a person go for assistance in a professional environment. There are community, religious and private organization which provide these services in reviewing a case to help get proper care. Today there are many books on the subject which are available to help get a good picture of issues and solutions, along with references that can be used to help plan and solve a situation which could bring about family crisis.

A good friend whose mother is 91 came to a sudden decision about two months ago. He was a full time care giver to his mother who had undergone open heart surgery. Prior to the surgery she exhibited no real signs of memory loss or disorientation, and after that surgery it became evident that she had. He sought out professional help with senior consultants and is preparing to arrange for his mother to enter a home which can best help her now and in the future by providing a safe enviorment with 24 care.

Another friend also in a similar situation found a community service organization and they are helping him to plan out the proper care and living arrangements for there mother including financial assistance.

Some family issues which a need for senior care can bring about are division among family members, unnecessary financial difficulties and other problems. A friend of mine recently related that his sister removed the mother from the home leaving the father helpless, and created a divorce of the parents, while the father ultimately was able to get into full time care these wounds may never heal.

Preplaning when you or a parent can best make decision's about future care is always something to seriously consider even if uncomfortable. Long Term Care can also be something which you can arrange for prior to need.

Consider the possibilities and if you are looking for resources, contact us at http://www.amsinsure.com/ for assistance. You can also email info@amsinsure.com .

How to legally terminate employee under California at-will employment laws.

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Give him 3 days to give you his own performance improvement plan and to rebut this warning. For transportation personnel, this also means disclosing recorded drug and alcohol abuse. One of the most trying parts about being a owner or Hr boss is dealing with problem employees. Decide whether you'll do voluntary or involuntary dismissals. Explanation of severance benefits in the lay off meeting. Because it is awkward for everyone, the dismissal of workers is not a common event. A difficult employee can easily be a safety hazard for your other employees as well as for him or herself. Will the company suspend the worker, will it dock pay, or will it fire the worker? Eventually, management will ask most supervisors to sack or layoff someone. If your small business doesn't have a conference room available, then use another manager's office, or use your own in a pinch.

In step two, you should discuss the issue with the at will worker. For example, a discontinuance package will reduce the sting of termination, sacking on Friday will reduce the humiliation, and having a witness in the meeting gives you extra physical protection. Don't sack workforce without evidence and before taking the time to seriously consider the ramifications. Are you a timid owner or Human resource person? 9) How To Fire an employee For Off-Duty Behavior And Lifestyle. The information you collect for the employee during this meeting will help you set the tone for the next actions in which you will take.

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This Just In

The IRS has added three types of expenses to the list of medical expenses approved for deductions and reimbursement under a Health FSA, Health Reimbursement Arrangement or a Health Savings Account. The first expense is an annual physical exam. The second is full-body electronic scans. Although often performed without a doctor’s recommendation, the IRS considers such scans reimbursable because they serve "no non-medical purpose." (It matters not that this procedure is typically expensive and that cheaper and possibly more effective alternatives exist, such as X-rays.) The third is pregnancy tests, including over-the-counter tests. Anxious mothers-to-be can take comfort that the IRS did not limit the quantity of tests that can be reimbursed.

For details, see
Internal Revenue Bulletin
2007-50, Page 1154:
www.irs.gov/pub/irs-irbs/
irb07-50.

Free Samples Are Expensive click here for more information!

People who get free prescription samples actually spend more on prescriptions in the long run. One reason is that patients continue the medicines even when there are less expensive alternatives. The study was supported by the Robert Wood Johnson Foundation. Additional authors are from Virginia Commonwealth University and the University of Chicago. Younger patients and those not on Medicaid received more samples. Out-of-pocket expenditures were $166 during periods before patients received samples; $244 during periods while patients were receiving samples, and $212 during periods after patients no longer received samples.

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How to choose a Hospital! click here

Reputation is what health professionals rely on most when seeking medical care, so it pays to ask around. Check with your physician, friends and family to learn about there experiences and get referrals. A little known secret, at least today and perhaps not tomorrow is to ask the people who work at a hospital what they think, you'll be surprised at the candid answer you get.

You will want to consider the size of the institution depending on the procedure and whether they have the latest techniques and equipment to get the best results. Public resources that survey and rate institutions can be helpful as well as web sites that discuss hospitals and medical topics.

Look to professional forums regarding the experience and expertize of the professional you choose, as well as there education, background and training. Once again rely on those you know or other professionals for references regarding who will be providing your treatment.

When choosing a Hospital check into there patient to nurse ratio and general staffing as well as the level of the staff as there experience in assisting with procedures which you will be undergoing.

You can check with news publications, periodicals which rate and evaluate hospitals as well as government resource. The more informed you are will help to assure the best outcome for good results and recovery.