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Monday, August 31, 2009

Companies Step Up Benefits Communication to Combat Unions

As discussions around the Employee Free Choice Act heat up in Congress, employers are stepping up their communications to employees about the benefits they offer as a way of combating unionization efforts.

Many employees do not understand their benefits and employers sometimes do not communicate benefits from health,pension and mandated state and federal programs. Comunicating these beneftis to employees so they truly know what the employer is paying for can greatly help employees appreciate whiat employers are providing for on behalf of the employee.\

We can assist employers in doing just that.

Tuesday, August 25, 2009

Truth in Health Care Reform Act, What you should know?

FACTS ABOUT: H.B. 3200 - America’s Health Choices Act

ACTUAL TEXT OF LAW:
Section 102: Grandfathered Health Insurance Coverage Defined

Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met.

Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

WHAT THIS MEANS:
Once the government-run program has started…

1. the employer sponsored program can not accept any new enrollees unless they are a dependent of someone already enrolled.

2. the employer sponsored insurance program can not make any changes to their program. Making changes to the employer program would eliminate the grandfather exemption!

Eventually all private, employer-sponsored programs would be eliminated.
These are the facts.

Wednesday, August 12, 2009

True Cost of Health Care and the Health Care Debate

The true cost of health care is often not well known by most people and its often difficult to see. 9 out of 10 people under 65 are covered by and employer plan. The cost is often split between the employer's share and the employee's share of the cost. While this is different for each company and has been changing in the last several years it can be 75/25% ER/EE split and cover just the employee cost or the family costs.

As an employee you tend to equate cost as your share of the premium where the employer will look at the total costs. This is often how many look at health care costs. The true cost of health care is made up mainly of claim costs plus the companies administrative cost. Insurance do such a good job of administration that it is less expensive for government plans to use the private sector such as medicare and medicaid. Even congresses very rich plan is in the private sector with a choice of plans and companies to choose from

Since claims can make up from 82 to 92% of the plan costs this is the area which needs to be looked at since even a small change can mean big dividends in lowering costs. An interesting fact is medicare which we have been told will be unable to continue sometime in the next several years because of rising cost. Now medicare was the first plan to set limits on its payements using DRG's and yet continues to expierence rising costs since the number of retiree's keeps growing and the age of retirees continue to rise, meaning more claims cost since aging means more medical issues as a natural process of aging.

PPO's and HMO's which also negotiate for contracts at better rates than the normal charges by providers continue show increased claim costs and therefore increased costs for benefits.

So whats the answer to these perplexing questions of costs and congresses lack of ability to address the real problems?

I believe real change means taking a long hard look at the issues, bringing together all parties to look at how they can contribute to a solution, and most of all some hard decissions that will not please everyone.

I would hope anything congress decides to do they include themselves in the solution which will mean they will protect us by protecting themselves.

Is there a Health Care Backlash Brewing?

PROVIDENCE, R.I. — Waiting in line at the pharmacy to pick up prescriptions, Lawrence Cafero Jr. can't help but feel a bit guilty.

Cafero is a state representative in Connecticut and taxpayers subsidize his generous health insurance plan, which requires only a $10 copay for any brand-name prescription drug.

"I'm standing behind either an elderly person or a working-family person and they're taking out wads, like dropping 20, 40, 60 bucks. And I've got $10 — $5 for a generic," said Cafero, R-Norwalk. "I'm embarrassed."

Pressure is mounting in states hit worst by the recession to take back some of lawmakers' generous health benefits that are funded by taxpayers.

A review by The Associated Press showed lawmakers in 12 states get health insurance for free, while those in 28 states share the costs with taxpayers, often getting a better deal than private sector workers.

In California, where finances are so bad the state has issued IOUs, the citizen commission that sets benefits for elective officials voted in June to reduce funds for lawmaker health insurance. The change takes effect in December.

"There are employees on furlough and people being laid off," commission member Ruth Lopez Novodor said. "It just didn't seem right to keep the compensation at the same levels."

In Michigan, supporters are renewing efforts to end lucrative retiree health benefits for lawmakers or at least force lawmakers to work longer before they qualify for them. Similar proposals failed in 2007.

"What's good for us should be good for them," said Ray Holman, a child abuse investigator for the Michigan Department of Human Services, who has seen his health insurance costs rise steadily. He will lose six days of pay this year as state leaders try to close a deficit.

"When you see the lawmakers who have the generous benefits and appear to be working part-time, it's just not good leadership," Holman said.

Meanwhile, many Rhode Island lawmakers accustomed to free health insurance at taxpayer expense have bowed to public pressure and started voluntarily contributing toward its cost.

Last year Rhode Island cut state-funded health care for immigrant children and 1,000 adults, forced the poor to take cheaper generic drugs and raised health insurance costs for state workers.

Yet Sen. Charles Levesque, D-Portsmouth, believes his free health care reasonable considering lawmakers make $14,018 in salary. Although they meet only about six months a year, Levesque, an attorney, considers his elected post a full-time job.

"I am the senator from Portsmouth when I walk out in my bathrobe to get my newspaper in the morning, when I go to the local pharmacy to buy whatever prescription medication I need to keep me going," he said.

Federal lawmakers, who are debating an overhaul to the nation's health care system, also get subsidized insurance. Members of Congress are covered by the federal employees health plan and get VIP medical access at Walter Reed Army Medical Center in Washington and the National Naval Medical Center in Bethesda, Md. For about $500 a year, federal lawmakers can also have unlimited visits with a physician assigned to the Capitol for routine care.

At Tuesday's town hall meeting in New Hampshire, President Barack Obama was asked why he hadn't talked more about the differences between the benefits offered to federal lawmakers and the system for everyone else. Obama responded that his proposal would give the public options similar to those given to federal employees.

Some state lawmakers also receive generous benefits:

_ Michigan lawmakers get retiree health care after six years of service and can tap into their benefits at age 55. That perk is the envy of workers in a state with 15.2 percent unemployment rate.

_ Members of the Massachusetts Legislature pay about $200 to $230 per month for family health coverage, about 18 percent less than what the average U.S. consumer pays, according to a national survey by the Kaiser Family Foundation and the Health Research and Educational Trust.

_ Connecticut lawmakers get retiree health insurance after working a decade for the state. Some lawmakers get retiree health care for free, while others pay 3 percent of their salaries. Brand-name drugs require a $10 co-payment.

In comparison, about 63 percent of employers offered health coverage last year, according to Kaiser's annual survey of roughly 1,900 firms. Health insurance for the average single employee ran around $4,700 annually, and workers paid 16 percent of the tab. Premiums for family plans averaged around $12,680, and workers were responsible for 27 percent of the cost.

The disparities could influence how lawmakers think, said Peter Sepp, a vice president for policy and communications at the National Taxpayers Union.

"It can skew their perspective on how much it might cost a family or small business to provide such insurance," he said. "It can also in some instances lead them to believe that the affordability of their coverage is something that the entire nation can be made to afford."

Not all lawmakers have it so easy. Legislators in New Mexico, South Dakota and Wyoming cannot get state health insurance, while their counterparts in Nebraska, Nevada, New Hampshire, West Virginia, Alabama and Vermont must pay the full price themselves if they want state coverage.

Vermont Rep. Carolyn Partridge, D-Windham, went without health insurance after being elected to office. As a farmer, she cannot afford to pay for the state health plan. Partridge and her husband now qualify for Medicaid.

They paid out-of-pocket for an annual physical and have avoided treatment for anything except emergencies. Partridge said hospitals are willing to work out payment plans for the uninsured.

"The bottom line is, you get taken care of," she said. "The worst bottom line is they take your house, if you own one."

In Rhode Island, House lawmakers passed a bill last year requiring lawmakers to pay 10 percent of their premiums, but it died in the Senate. A similar bill sponsored by Rep. Amy Rice, D-Portsmouth, never made it to the floor this year.

Sunday, August 09, 2009

Congress and Health Care

Congress and senators went home and hold town hall meetings on Health Care it quickly became apparent that there was a strong movement aginest a public program and maybe even a legislative solution.

While we look like we are a long way from seeing a formal bill there are many things being run through the legislature. One of the most salient points I believe is that there is no participation by the legislature in any plan they propose and even some that specifically excludes them. If Mr. Obama, the legislature and government employees won't participate, then a question arises as to why. Simply put they want to force us to have less while maintaining there rich benefits. I feel a solution which could work puts everyone in the same boat.