White paper uploaded on how a small business can survive during recession

A white paper for small business entrepreneurs has been uploaded to the blog. This paper exclusively covers the planning and strategy one should follow during recession. It is based on comprehensive research and the advices from small business experts.


You can download it from the download section with a title: This article was on Linked in Portal and is a good way to work with other business all looking to be mutually supportive.




“How Small Businesses Can Survive Recession”



Let us in addition to the points in the white paper help to reduce your companies;



Benefits costs:



Payroll costs:



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A great tool for business if you have not found it is Linked In (google it), please look for my profile also, under John A. Beyer, Agency Marketing Service.

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National Results: 2008 UBA Health Plan Survey

Annual Benchmark Survey Shows Average Annual Health Plan Cost is $7,327 Per Employee; Largest Percentage Increase in CDHP Adopters Comes from Employers in the Northeast with a 90% Increase Over the 2007 UBA Health Plan Survey Results.

With responses from 18,019 health plans sponsored by 12,860 employers nationwide who employ nearly 2.4 million people (approximately 5.4 million employees and their families), the 2008 UBA Health Plan Survey is the nation's largest and most comprehensive survey of plan design and plan costs. "With a growth rate of approximately 10 percent over last year's previously unprecedented number of respondents, the report defines benchmarks for a greater number of specific industries, regions, and employee size categories than have been available previously," said Bill Stafford, UBA’s vice president of member services, "The results will be especially valuable to employers in evaluating the effectiveness of their current plans and to knowledgeably making future adjustments while keeping their benefits competitive and cost-effective."

"Certainly the continued growth of CDHPs is a key headline to come out of this year’s survey," said Stafford. "Fee For Service and Exclusive Provider Organizations have now virtually disappeared from the market, and HMOs are losing ground as employers seek to help contain the rising cost of health care and insurance premiums."

Leading the News on Doctors requesting fees up front

More physicians said to be seeking medical fees at time of service.

On the front page of its Health section, the Washington Post (3/3, HE1, Kritz) reports, "More and more physicians are asking for the patient's share of that day's medical fees, including any deductible set by the insurer, at the time of the visit." According to Red Gillen, an analyst with consulting firm Celent, "in the past few years...employers and insurers have shifted more [medical] costs to consumers," and as a result, those payments are "an increasingly large share of doctors' incomes." And, "largely through new software programs that assess both a patient's insurance coverage and the day's charges," patients can now see "a full adjudication of the bill" within "just minutes" of their visit.

But, Mark Rukavina, executive director of the Access Project, notes that "not all providers have let their patients know that payment[s]...are expected at the time of care."

William Dolan, a trustee of the American Medical Association, and an orthopedic surgeon, explains that "the AMA has no policy on patients being asked for payment at the time of care but suggests that doctors give patients warning weeks before implementing a new payment policy."

Lean Times Call for Cutbacks in Health Care Benefits

Bailout Offers Some Relief to Unemployed, But Part-Time Staff Stand to Lose Insurance

Employers are cornered into making distressing decisions between providing health care benefits to workers and staying in business during a recession, say experts.

“Employers are cutting benefits for part-time employees,” says John Beyer, owner of AMS Benefits Insurance Services, an insurance broker. “We are definitely seeing employers require increased employee participation in the monthly premiums.”

Though insurance lines have decreased in premium price, health care rates are rising, in turn causing reduction in staff for employers and loss of benefits for employees and their dependents.

He adds that health insurance premiums were a source of concern even before the downturn.

To help you find better cost solutions for your company:

http://www.amsinsure.com/ or 800-334-7875

The Furlough Weekend: An Alternative To Layoffs?

Would you like 10 more three-day weekends per year?

Would you still take them if the third day was unpaid -- and if your alternative was getting laid off?

One of the biggest costs of any employer is payroll. In the ongoing economic crisis, employers are looking for any way to cut costs and many are resorting to layoffs.

But many others — from an RV-maker in Oregon to the state government of California — have turned to involuntary furloughs, or unpaid days off, as a way of cutting payroll costs while avoiding painful layoffs.

That got us here at The Ticker thinking: What if employees facing furlough could choose their furlough days?

Call it the Furlough Weekend.

While this idea may not be for everyone due the type of work, importance of a worker or manager it can be employed by those who would be creative and want to keep valuable workers availabel for the future when the economy will turn around.

It's time to fix the 401(k)

The 401(k) plan can be a powerful savings tool. But for more of us to enjoy a secure retirement, we need a bigger, better idea.

Alicia Munnell is a Harvard-trained economist. She served as an assistant secretary of the Treasury and is regarded as one of America's foremost experts on 401(k)s. You'd think she'd be terrific at managing her own retirement, but even she has to fess up to some mistakes. "When my son got married, I took some money out of my plan to help," says Munnell, who heads Boston College's Center for Retirement Research (CRR). "And I ended up paying a 10% penalty and taxes."

In the jargon of the retirement business, that's called leakage. It's a common problem: About 60% of job switchers with a 401(k) plan cash it out.

That's just one of the many pitfalls. Lots of people start saving too late, save too little or make missteps with their portfolio. And all of us are vulnerable to risks that we can't control. Your employer might not offer a plan or might choose one with second-rate investments. Or you may hit a market storm at precisely the wrong moment: the year you stop working.

That last problem is especially obvious now. Over the past 12 months, a 64-year-old investor in an age-tailored "target date" mutual fund has lost 26%. Savers with high balances can recover from that. But many lost more, and the typical near-retiree with a 401(k) has less than $50,000 stashed away in it. That will spend down quickly, and once the money's gone, it doesn't matter if the market roars back.

A recent CRR study shows that a bear market retiree could easily end up with just half the income from a 401(k) as someone retiring during a bull market. "Any system that delivers such wild swings in retirement income is just not working," says Munnell.

She isn't the only one who's worried. A growing number of policy experts who study 401(k)s think they fall short. So why not rethink America's retirement system from the ground up? No, it won't be easy: We're in an economic crisis, and lobbyists for the financial services industry will fight like tigers for the status quo. But that doesn't make the task any less urgent. Some 78 million baby boomers are hurtling toward retirement. Their poverty, if it comes to that, will be a burden to their children and lead to calls for taxpayers to support them.

What would a better system look like? It would be universal and strike a more conservative balance of risk and return. Most of all, it would be designed for savers, not employers or money managers. Here are five principles for reform.

To learn more:

It's time to fix the 401(k)

Tool of the Month: Employee Handbook

While it is considered a best practice as oppose to a legal requirement to have an established company Employee Handbook, not having one could put your business at greater risk of unfair employment-related claims.

An effective Employee Handbook should include topics and items such as:

At-Will Statement,
Equal Employment Opportunity Statement,
Harassment Policy,
Confidentiality Policy,
Disclaimer, and
Acknowledgement of Receipt.

In the HR Support Center website under the “Essentials” tab section, you can easily download a sample template for handy reference. A free Value Added service to our clients.

Study suggests seniors who reach Medicare's "doughnut hole" are less likely to use prescription drugs.

CQ (2/4, Attias) reports, "Two studies released Tuesday show that, while the Medicare Part D drug benefit reduced out-of-pocket spending for seniors and increased their use of essential medicines during its first year in 2006, Part D patients increased their use of less beneficial medications and decreased medication usage when they entered the coverage gap known as the 'doughnut hole.'" Therefore, the studies' authors "recommended redesigning the benefit to provide additional coverage in the doughnut hole to prevent adverse health effects in seniors." CQ notes that the "coverage gap was originally implemented to keep the cost of the program within the amount specified by the congressional budget resolution." Although "the Centers for Medicare and Medicaid Services did not comment directly on the studies, agency spokesman Peter Ashkenaz said CMS data show that in 2007 and 2008, the average number of prescriptions filled showed little change as enrollees entered the coverage gap." Both studies were published online in Health Affairs.

Americans with Disabilities Act (ADA)_Employers with more than 15 EE's

Effective January 1, 2009, The ADA Amendments Act of 2008 (ADAAA) redefines who is considered “disabled” under the ADA and thus leads to a potentially larger number of “disabled” employees seeking accommodations and of those who may claim they were “regarded as” disabled in unfair treatment claims. (Note: The Americans with Disabilities Act (ADA) applies to businesses with 15 or more employees.)

Highlights include:

Covered Individuals. The number of individuals covered by the ADA will increase including those with:
Conditions corrected by medication (i.e. diabetes, epilepsy),
Conditions currently in remission, and
Conditions that are episodic.

Reasonable Accommodation and the Interactive Process.

Make sure job descriptions are current and relevant,
Maintain an on-going dialogue with employees who may have a disability that needs to be accommodated, and
Document any evidence and / or discussion about potentially providing reasonable accommodation.

KEEP UPDATED ON HR with AMS and HR Answerlink; ask us how, for our Clients

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

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