The Healthcare Survival Guide

The Healthcare Survival Guide

Importants of HR in a down economy

In this down economy, HR faces some serious risks as employees are worried about money and the possible loss of their jobs. Nonetheless, HR managers can be proactive to protect their companies from harm.


Here are just a few things to consider:



1. The Pilfering Privilege. The risk of employees accessing company documents and trade secrets is high, because employees have access to much of the company's data through computer usage.



2. Txtul hrsmnt--no lol (Translated: Textual Harassment--not laughing out loud). Inappropriate texting leading to harrasement claims.



3. $how Me the MONEY! Wage and Hour claims.



4. We Shall Overcome. Possible unionization of workplace.



5. Will You Still Love Me When I'm 64? Age discrimation claims on the rise.



This is only a partial list where employers may want to cosider the need of an HR program to help answer questions, defense againest problems, and help ease the consequence of a problem.



OUR value added resources are available to clients of AMS.

Medicare Changes will still be good business for carrier's even with changes

Oct. 20 (Bloomberg) -- Insurers led by United Health Care Group and Humana Inc. rose in New York trading after UnitedHealth Chief Executive Officer Stephen Hemsley said Medicare will stay a profitable business even with cuts in government payments.

Higher premiums and other benefit changes will keep up Medicare profit margins even with U.S. plans to cut insurer payments by 5 percent, Hemsley said on a conference call. That optimism, along with UnitedHealth’s success at holding down medical costs, bodes well for other insurers, said Jason Nogueira, an analyst at T. Rowe Price Group Inc. of Baltimore.

Small Business and Health Care Reform

Small businesses around the country have rallied around legislative measures that would force insurers to accept all applicants and offer government subsidies to low-income workers, they've winced at mandates to provide coverage for every employee or pay a penalty equal to as much as 8 percent of payroll.

“They really want reform, but then there are the ones thinking, ‘How much will this cost me, and will it hurt my business?’ ” said Amanda Austin, the lead Washington, D.C., lobbyist for the National Federation of Independent Business. “It's a little bit of a mixed bag.”

About 70 percent of the small-business owners in California who provide health coverage to workers are straining to continue the benefit, while 86 percent of those who don't blame high premiums, according to a poll published in August by the nonprofit Small Business Majority, a national group based in Sausalito.

In a separate study, the organization concluded that he

Health reform legislation as currently envisioned in Washington could cut small businesses' medical costs by as much as $855 billion nationwide over the next decade.
“The basic framework in D.C. is certainly much more helpful to small businesses than doing nothing,” said John Arensmeyer, founder and CEO of Small Business Majority.
Overall, the small-business community's mixed reactions help to explain why its voice largely hasn't been heard in recent months amid intense debates on Capitol Hill and in town hall meetings nationwide.

Unlike big corporations and generously funded special interest groups, most small-business owners are too busy running their shops, bakeries, salons, restaurants and professional firms to study proposals that fill thousands of pages.
“It's an incredibly complex issue,” said Marshal Scarr, a partner in the downtown San Diego real estate law firm Peterson & Price. “It's hard to know what is the best thing to do, and it's hard to know what is realistic and effective.”

Small businesses, the self-employed and those with fewer than 500 workers number 26.9 million. They employ roughly half of the nation's work force — or more than 60 million people, according to the National Small Business Association.

California had 637,730 companies that each employed fewer than 20 workers in 2006, the most recent year for statistics from the U.S. Small Business Administration. The figure accounted for 88 percent of all companies in the state that year.

Health care analysts generally agree that small businesses have fewer options than large corporations for dealing with ever-rising medical costs, including the ability to use large numbers of potential enrollees as leverage during negotiations with insurers.

Forty-nine percent of U.S. companies with three to nine employees and 78 percent of businesses with 10 to 24 workers offered health coverage last year, according to a July report from President Barack Obama's Council of Economic Advisers.

In contrast, the council reported, 99 percent of companies with more than 200 workers provided health insurance.

Health Insurance Carriers not imune to the economy.

Like many companies Wellpoint, Inc. (the countries largest health insurer) has just anounced some lays and changes to there employees health plans. This change means higher dedcutibles and costs with more premium comming out of there pay checks. As enrollments have shrunk from higher unemployement and costs reducing the number of people covered by health inurance like other businesses a change comes about in income and benefits.

Does your business need to trim costs, check with us and we can help you in the small business market with 2 to 50 employees.

Nearly Half of Employers Now Auto-Enroll Employees in 401(k) Plans, Watson Wyatt Survey Finds

WASHINGTON, Sept. 23 /PRNewswire-FirstCall/ -- In a trend that is likely to continue, nearly half of U.S. companies are automatically enrolling workers into 401(k) plans to encourage them to save for retirement, according to a survey by Watson Wyatt, a leading global consulting firm. The survey also found that the number of companies that use target-date or lifecycle funds as their default investment option has increased sharply in the last few years.

"Employees need to participate more effectively in their company defined contribution plan as this is increasingly the primary vehicle they use to save for retirement," said Chris DeMeo, senior investment consultant at Watson Wyatt. "Taking an interest and actively participating in their plans will allow employees to make more informed decisions and develop investment strategies that take into account their goals and risk profiles."

The survey found that nearly half of surveyed companies (47 percent) now auto-enroll their employees into their defined contribution (DC) plan. Additionally, one-third of those that do not currently auto-enroll are considering it. Watson Wyatt's survey was conducted in March and April 2009, and includes responses from 149 mainly large companies, representing a total of more than 2 million employees across a broad range of industry sectors.

Nearly all companies (96 percent) have a default investment option. The number of companies using lifecycle or target-date funds as their default investment option has increased significantly, from 38 percent in 2006* to 62 percent today. More than 10 percent still offer stable value and money market funds as their default, despite Department of Labor (DOL) regulations issued in 2007 that stated that these options would not be given fiduciary protection.

Plan sponsors that auto-enroll their employees use a median initial contribution rate of 3 percent, with a range from 1 percent to 7 percent. Slightly more than half (51 percent) of the plan sponsors that auto-enroll also automatically increase the contribution rate by a certain amount each year for their participants. The final contribution rate is between 3 percent and 20 percent, with a median rate of 6 percent.

"While plan sponsors have made progress towards encouraging greater participation, saving and educated decision making, there is still room for improvement," said Robyn Credico, senior retirement consultant at Watson Wyatt. "Designing the optimum plan is tricky and requires plan sponsors to juggle many factors including overall plan design, investment, communication and governance. However, the potential upside is great and could cause DC plans to emerge stronger from the current economic crisis."

Employees and Employers Reveal High Satisfaction and Improved Cost Control with HSAs, Surveys Report

Most employers and account holders utilizing Health Savings Accounts (HSAs) and HSA-qualified health plans are satisfied with their coverage, spend less, and are more engaged in managing health benefits, separate surveys released today indicate.

The tax-favored health care savings accounts are designed to help individuals pay for current qualified health care expenses and save for future medical and retiree health care expenses.
"With the vigorous debate over health care reform, and more specifically health insurance reform, the survey results indicate that employers and account holders more effectively control costs and are satisfied with their coverage by utilizing HSAs," said Tom Hricik, national director, AMS Groups or AMS Personal Plans.

"The survey results also indicate that HSAs are being used by account holders as an important vehicle to save for future medical expenses."

Health Savings Accounts provide a convenient way to pay for today's health care expenses and to save and invest for the future.

Voluntary Dental Plans good for small business owners!

In today's economy, many small businesses find themselves struggling to add or retain employee benefits. Before an employer considers dropping dental benefits, it should consider a AMS Dental voluntary plan.




How it works
Voluntary plans offer convenience and cost savings for both employers and employees.
• The plan is sponsored by an employer and allows employees to choose whether or not to sign up.
• Employees who elect the coverage pay part of or the entire premium, while enjoying a group rate for the plan.
• The employer collects monthly premiums through payroll deductions and submits eligibility information to Delta Dental.

Benefits of a voluntary plan
The voluntary plan is a great option for groups looking to reduce their costs while still offering their employees comprehensive group dental coverage.
• Plans encourage regular use of diagnostic and preventive services (such as cleanings), reducing long-term costs for both employee and employer.
• Improved oral health can lead to better overall health and fewer days away from the job for oral or other health problems.

Unique benefits of AMS Dental voluntary plans
In addition to the usual elements of a voluntary plan, Delta Dental offers some unique features that may appeal to both employers and employees.
• An extra cleaning each year for pregnant women
• Coverage for implants
• Coverage for dental accidents
• Shelf-rates (that is, the same rate for all groups, regardless of level of employee participation)
• Low average annual rate increase (an average increase of only 2.9 percent over the past nine years)

Voluntary PPO plans are available for employers with five to 99 eligible employees. If you'd like more information about Delta Dental's voluntary plan offerings, please contact info@amsinsure.com

A Guide to State Guaranteed Coverage in California

The purpose of this post is to provide a concise guide to purchasing guaranteed issue individual health insurance in California. If you have questions, please leave a comment.

Healthcare Reform – Recent Developments

Recent Developments;

August began with the House Energy
and Commerce Committee striking a
deal with the fiscal conservatives
Democrats and approved e a 1,000-
page bill that:
• Eases employer mandates
• Reduces plan costs below $1 trillion
• Trims down public option; ability to
negotiate payments with providers
• The August recess began with townhalls
where a cross-section of
constituents expressed concern,
anger, and, at times, protest over health
proposals being discussed
• The White House responded with its
series of town-hall meetings to correct
misconceptions over reform
• Initial messaging by the White House
seemed to be downplaying the public
option in a possible bid to renew bipartisan
efforts for reform
• However, the possibility of reform
without a public option drew strong
opposition from liberal constituents
as well as Progressive Democrats

Concerns:

• Town-halls during the recess are having
a significant impact on the debate,
centralizing it over few key points
• Price Tag: $1 trillion price tag has
emerged as a major concern for a
significant cross-section of town-hall
attendees
• Public Option: Billed by critics as
govt.-takeover of healthcare, it remains
a core concern; insurance co-ops are
being touted as an alternative
• Death Panels: House reform bill drew
ire over so-called “death panels”, a
tangential reference to “living wills” and
other “end-of-life” care aspects
• Medicare Savings/Donut hole:
Seniors raised concerns over proposal
to draw savings from Medicare for
setting-up a new public option
• Supporters of reform, on the other hand,
do not see any proposal without a
public option as meaningful reform
• Several supportive legislators have
publicly stated their complete
opposition to any such bill, leaving
little room for any compromise

What Next?

The debate in town hall meetings
during the first weeks has given
opponents confidence in their stand
• On the other hand, supporters of
reform are increasingly apprehensive
of any bi-partisanship, thus favoring a
“go-it-alone” strategy
• President Obama is under pressure
from the Democratic legislators to
clarify his expectations from the
reform bills, something he has not
done assertively, so as to not hamper
any scope of bi-partisanship
• Until the Congress reconvenes,
Obama is likely to push to generate
public opinion in favor of reform
• However, White House may also
cement the divide within Democrats
between the conservative Blue Dogs,
moderate Democrats, and the
Progressive groups and prepare for a
“go-it-alone” legislation
• Overall, the jury is still out over the
fate of achieving comprehensive
health reform legislation in the next
session of Congress, even by the end
of 2009

I-9 Handbook

The I-9 Handbook for Employers is a useful reference, especially in light of the newly-revised Form I-9. Every business needs to know the required process for verifying an employee's employment eligibility. The handbook explains:
• Why employers must verify employment eligibility of new employees,
• The process of completing the employment eligibility verification form,
• Unlawful discrimination and penalties for prohibited practices,
• ...as well as important supplemental information.
In the HR Support Center website under the Essentials tab section, simply search for this helpful reference document in the Guides area (as well as the new Form I-9 in the HR Forms area).

New Form I-9 Available.

The U.S. Citizenship and Immigration Services (USCIS) has updated the Form I-9 (revision date of 8/7/09). While the previous form dated 2/2/09 remains acceptable, the recommendation is for all employers to start using the newly updated Form I-9.

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.

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.

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.

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.

CDHP's and the small business owner

What Does Consistent Participation in 401(k) Plans Generate?

This Issue Brief presents recently available longitudinal data from the EBRI/ICI 401(k) database on consistent participation in a 401(k) plan, through year-end 2007.

Looking at consistent participants in the EBRI/ICI 401(k) database over the eight-year period from 1999 to 2007, the average 401(k) account balance increased at an annual growth rate of 9.5 percent over the period, to $137,430 at year-end 2007.

The median 401(k) account balance (half above, half below) increased at an annual growth rate of 15.2 percent over the period, to $76,946 at year-end 2007. Data for 2008 are currently being analyzed and are expected to be published later this year.

Disability Awarness

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