Study Shows Members Enrolled in CDHPs Experience Lower Health Care Costs

Today, the operator of Blue Cross and Blue Shield of Texas (BCBSTX) released the results of its annual Consumer Directed Health Plan (CDHP) study. The study shows that individuals enrolled in CDHPs continue to experience lower health care costs and take advantage of more preventive health measures, long after switching from their traditional insurance plans.

In fact, the study found that after switching from a traditional plan to a CDHP, members saw a three-year average reduction in:

• Medical expenses — decreased by 11.8 percent
• Overall spending, combined medical and pharmacy costs — decreased by 10.5 percent
• Inpatient care costs — decreased by 23.5 percent
• Outpatient care costs — decreased by 5.1 percent
• Professional services costs — decreased by 14 percent

IRS Publishes Form Drafts for New ACA Employer Reporting Requirement

Please note; check with your payroll or HR provider for information.

On Thursday, July 24, 2014, the IRS published highly anticipated drafts of the forms large employers with 50 or more full-time equivalent employees will be required to use for the Code 6056 reporting requirement.  Code 6056 requires applicable large employers to file a transmittal with the IRS (Form 1094-C) and provide a new return to employees (Form 1095-C) in January 2016 for the 2015 calendar year.  This reporting requirement has a triple purpose, as it is designed to allow the IRS to enforce the employer mandate, enforce the individual mandate, and confirm eligibility for premium tax credits for coverage purchased through an Exchange.

This reporting and disclosure requirement is new for employers and may catch some employers off-guard.  For example, the reporting requires collection and disclosure of information including, but not limited to, the following:

• Social Security numbers of employees, spouses and dependents;
• Names and EINs of other employers within the employer’s controlled group of corporations for each month of the calendar year;
• Number of full-time employees for each calendar month;
• Total number of employees (full-time equivalents) for each calendar month;
• Section 4980H transition relief indicators for each calendar month;
• Employee’s share of the lowest-cost monthly premium for self-only, minimum value coverage for each calendar month; and
• Applicable Section 4980H safe harbor for each calendar month.

Please note these forms are in draft form only and are subject to change. The IRS has not yet released instructions for the forms, which should provide the detail necessary to complete some of the more ambiguous cells in the forms. The first transmittal and returns will not be filed until January 2016, but much of the information must be reported for each calendar month of 2015. Ensuring internal time and attendance systems, record management, and payroll systems are capable of producing the required information is critical. Although there is much information left to be released by the IRS concerning the Code 6056 reporting requirement, employers subject to this requirement should begin preparing now.

More Patients Are Visiting Retail Clinics

Retail clinics are playing a growing role in health care delivery, according to a study from Walgreens. Patients are relying more on nurse practitioners at retail clinics to provide chronic and preventive health services. The study also reveals marked increases in the number of patients who are making return visits to clinics. Visits to healthcare clinics for preventive services, screening, and chronic care increased from 4% in 2007 to 17% in 2013. The annual percentage of return patient visits to Healthcare Clinic climbed from 15% in 2007 to more than 50% in 2012 and 2013. For patients age 17 and under, visits for preventive services and vaccinations increased 180% For patients ages 18 to 64, visits for health testing increased 90% while preventive health service visits increased 66%. Acute visits increased 84% for patients 65 and older. The Convenient Care Association estimates that 33% of Americans live within 10 minutes of a retail healthcare clinic. Walgreens has increased the variety of services at select Walgreens clinics from providing vaccinations to diagnosing and treating a number of chronic conditions. Clinics at select locations are open seven days a week, with extended evening and weekend hours, and offer walk-in service. Healthcare Clinics accept most major insurance plans and Medicare and Medicaid, and offer affordable, transparent pricing for those without insurance coverage. Healthcare Clinic’s board-certified nurse practitioners and physician assistants deliver patient-centric care, driving patient satisfaction rates that are consistently greater than 90%. For more information, visit www.walgreens.com.

Insurance Insider News:Insurance Insider News: Employees Unhappy with Benefits

by Leila Morris

When asked how they like their benefits, employees gave the lowest rating in six years, according to a survey from Unum. Only 47% say their benefits are excellent or very good. Only 33% say that the benefit education their employer provides is excellent or very good, and 28% say their benefit education is fair or poor. This is a reversal to the upward trend in ratings since 2009. Only 49% say their workplace is excellent or very good. Seventy-seven percent of workers who say their benefit package is excellent or very good also say the same of their employer. In contrast, only 17% of employees who say their benefit package is fair or poor also say that their workplace is excellent or very good. And 79% who say their employer’s benefit education is excellent or very good say the same of  their employer — compared to only 30% of those who say their benefit education is fair or poor. Bill Dalicandro, vice president of the consumer solutions group at Unum said, “This research underscores the value of an effective benefit education plan because when an employee understands their benefits, they tend to value them more and…may value their employers more for providing access to them.”

DOL limits employer contributions for medical FSAs

A recent technical release issued by the U.S. Department of Labor imposes severe dollar limits on employers wanting to make pre-tax contributions to the medical flexible spending accounts for eligible employees. READ MORE »