COBRA/State Continuation Subsidy Extension

On April 15, 2010, President Obama signed into law the Continuing Extension Act of 2010 (HR 4851). Among other provisions, this law once again extends the COBRA subsidy eligibility period under ARRA, this time through May 31, 2010.

As with ARRA, the changes affect continuation coverage offered under COBRA and any comparable state law. Like its COBRA predecessors, this law takes immediate effect and is retroactive to April 1, 2010.

The law makes the following changes:

New Sunset Date: The COBRA subsidy eligibility period (for Qualifying Events on or after September 1, 2008) now ends on May 31, 2010. This period had expired on March 31, 2010. As a refresher, the subsidy is a 65 percent discount off the regular COBRA premium for up to 15 months. Only Assistance Eligible Individuals (AEIs) qualify for the subsidy.

Eligible Qualifying Events: As before, two types of Qualifying Events are subsidy eligible. The first one is an involuntary termination of employment. The second one is a reduction in hours followed by an involuntary termination of employment if that involuntary termination occurs on or after March 2, 2010, and on or before May 31, 2010.

The new law does not change the length of the COBRA maximum coverage period. It is still based on the original reduction in hours Qualifying Event date. Also, the subsidy period (up to 15 months) is unchanged.

UPDATE on Health Care Reform

As you know, Health Care Reform has passed and continues to be discussed and analyzed and debated! To help you understand how this reform will affect you and your employees, we have attached a simplified timeline for the major components of the law.

In the immediate future (for groups renewing in October 2010 and each month thereafter) the major changes that will affect your health insurance policy in 2010 are:

1. Dependent Children will be covered to age 26
2. Bans lifetime and annual maximums
3. Children cannot be excluded from group or individual coverage for pre-existing conditions.
4. Requires insurance carriers to fully cover preventive care services (with no cost sharing by subscriber)
5. Provides a Tax Credit available for Small Employers (under 25 employees for calendar year 2010) who purchase health coverage for their employees.

PLEASE SEE THE LINKS BELOW FOR MORE DETAILED INFORMATION
ABOUT THIS PROVISION.

http://www.irs.gov/newsroom/article/0,,id=220809,00.html?portlet=6

http://www.irs.gov/newsroom/article/0,,id=220839,00.html

http://www.irs.gov/pub/irs-utl/small_business_health_care_tax_credit_scenarios.pdf

http://www.irs.gov/pub/irs-utl/3_simple_steps.pdf

A few other items to be aware of that will become effective in 2011:

1. Employees who have access to a Flexible Spending Account (FSA) will no longer be able to be reimbursed through the FSA for over the counter drugs.

2. Employees who have access to an HSA account will now be taxed 20% (was 10%) for non-qualified medical expense distributions.

We will continue to keep you updated on any changes in the law or updates as we are notified. We also would encourage you to sign up on the State of Oregon DHS website, for daily updates to Health Care Reform. That website is: http://insurance.oregon.gov/FAQs/fedrealhealthreform-oregon.html

The CLASS Act (part of Health Care Reform)

There is a small “hidden” provision that was deep in the heart of the Health Reform Law that was passed, which may escape people’s radar, but is important for employers to know about. It is THE CLASS Act (Community Living Assistance Services and Support). This is a government sponsored, long-term care plan that offers a basic level of guaranteed issue coverage to working Americans. Employers will be strongly encouraged to offer this plan, but it will not be mandatory. As of now, it appears that all working Americans will be automatically enrolled in this program unless they choose to opt-out. Premiums have not been set, but they will be automatically deducted from employees’ checks. The government is hoping to raise revenue with this product to help pay for the cost of the Health Care Reform.

Employee Benefits Department Contacts:

Suzie Moll, Employee Benefits Manager

Stephanie Bartrug, Employee Benefits Specialist

Robert Rivenburgh, Employee Benefits Specialist

Jared Harding, Employee Benefits Specialist

Lisa Ewers, Office Support, Individual/Medicare

COBRA/State Continuation Subsidy Update

A new federal act, HR 4691 now extends the eligibility period for the American Recovery and Reinvestment Act premium subsidy for an additional 31 days (through March 31, 2010) and clarifies eligibility for the subsidy resulting from an involuntary termination of employment that follows a period of reduction in hours of work that caused an individual to lose health benefits under a group health benefit plan. These temporary rules make the same changes to the state continuation program allowing Oregonians enrolled in the state continuation plans to receive the maximum subsidy provided by the federal law.

More information can be located at: http://insurance.oregon.gov/FAQs/federal-stimulus-cobra-faq.html#eligibility

Premium Assistance Helps Families Afford Coverage
If employees are eligible for your group health coverage, but are unable to afford their portion of the premiums or dependent coverage, a state premium assistance program may be able to help. Several states use funds from their Medicaid or Children’s Health Insurance Program (CHIP) programs to help people who are eligible for employer-sponsored health coverage, but need help in paying their health premiums.
As part of Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), employer groups with plan years beginning after February 4, 2010, are required to notify employees of possible premium assistance under state Medicaid and CHIP programs annually.
Oregon:
• Medicaid Web site: http://www.oregon.gov/DHS/healthplan/index.shtml
• Medicaid phone: (800) 359-9517
• CHIP Web site: http://www.oregon.gov/DHS/healthplan/ app_benefits/ohp4u.shtml
• CHIP phone: (800) 359-9517
Washington:
• Medicaid phone: (800) 562-3022
• CHIP Web Site: http://fortress.wa.gov/dshs/maa/chip/
• CHIP Phone: (866) 543-7669
• SHIBA FAQ Sheet: http://www.insurance.wa.gov/publications/shiba_helpline/Losing_employer_insurance.pdf
Here is a link to the Model Notice: http://www.dol.gov/ebsa/chipmodelnotice.doc
For more information on special enrollment rights, please visit the U.S. Department of Labor Employee Benefits Security Administration Web site at www.dol.gov/ebsa.

Health Care Reform

On Sunday, March 21, 2010 the House narrowly approved the Senate-passed healthcare reform bill by a vote of 219 to 212. The bill will be sent immediately to President Obama to be signed into law in a ceremony expected on Tuesday.

Also Sunday night, the House approved the reconciliation bill containing “fixes” to the Senate-passed bill by a vote of 220 to 211. The reconciliation package will now go to the Senate, where it is expected to face numerous procedural challenges and amendments. If the Senate adopts any changes to the proposal, the House will have to take another vote on the reconciliation bill.

We will continue to keep ourselves apprised of these matters as they develop and we will make certain to advise you of any changes that occur that could impact your coverage.

Supplemental Benefits

As insurance costs rise employers are making the choice to modify their benefits to keep their plans as affordable as possible. We recognize that this is a difficult decision and we want to offer assistance in finding creative ways to cover the gap that higher deductible plans can leave. As such we have partnerships with both Aflac and Colonial Life. Both carriers offer a variety of accident and sickness plans that employees can purchase to help cover their out-of-pocket expenses. If you would like to learn more about these options please contact your agent.

Individual Plan Updates

Keep in mind Clackamas Insurance is a full-service agency. If you or your employees need assistance with an Individual medical, dental or Medicare plan, please contact Lisa Ewers at 503-655-6344 or email lisa@clackamas-ins.com.

¬¬¬¬¬¬Employee Benefits Department Contacts:

Suzie Moll, Employee Benefits Manager 503-655-6344 ext 33
Stephanie Bartrug, Employee Benefits Specialist 503-655-6344 ext 27 Robert Rivenburgh, Employee Benefits Specialist 503-655-6344 ext 32
Lisa Ewers, Office Support, Individual/Medicare 503-655-6344 ext 31

Clackamas Insurance was founded in 1972 by Karl Moll and today is run by his son, Mike Moll, with locations in Clackamas and Sandy.

Spokeswoman Mitzi Thornberg says in regards to their expansion, “We’ve always had close ties with the agricultural industry, so Marion County seemed a perfect fit for us.”

Premier Insurance has served the Salem community for more than 30 years. Thornberg says “The purchase by Clackamas Insurance brings a much broader level of diversity.”

“Workers’ compensation is one area where we feel we offer a huge advantage to our clients.”

Clackamas represents more than a dozen major insurance carriers, including Mutual of Enumclaw, Liberty Northwest and Oregon Mutual.
The firm offers business, farm, home, auto, workman’s comp, and  life and health insurance.

“Our hope is to fill the void created by other independent agencies who have recently left the Salem area,” Thornberg said, including Wells Fargo Insurance Services.

The agency has 11 staffers, including the two previous owners, Kirk Marley and Rex Rider, who will stay on as agents. “We don’t expect to make any new hires at this time,” Thornberg said. “Given the addition of new carriers and products, we will be expecting to increase our customer base and will need to address additional staffing as the need arises.”

Plan sponsors must notify participants of a plan’s creditable prescription drug coverage status at least once a year by November 15. The notice must be provided to all Part D-eligible individuals who are covered under, or who apply for, the plan sponsor’s prescription drug coverage. 

These individuals include Medicare beneficiaries who are active employees, disabled, on COBRA/State Continuation, as well as Medicare beneficiaries who are covered as spouses or dependents (including those spouses or dependents who may be disabled or on COBRA/State Continuation) under active employee coverage.  

Typically it may be hard for a group administrator to discern who meets this criteria especially when it comes to spouses and/or dependents, so it is our recommendation that you send the notices to all employees and their families. This is especially important if a plan is not creditable, because participants in a non-creditable plan will pay a penalty if they later enroll in Medicare Part D.  

In addition, plan sponsors must provide notice of creditable coverage annually, when a beneficiary first becomes eligible for Part D, when plan changes are made, or when a beneficiary requests it. Failure to properly inform plan participants of creditable coverage status could cost participants significantly if they later elect to enroll in Medicare Part D instead of the plan sponsor offering.  

Finally, you also are required to disclose the creditable coverage status of your plan to CMS via the Disclosure to CMS form on the CMS website. The disclosure must be made to CMS on an annual basis, and upon any change that affects whether the coverage is creditable.  The link to the CMS website is below.   

   https://www.cms.hhs.gov/CreditableCoverage/45_CCDisclosureForm.asp

You should be receiving a letter from your health plan that will notify you if your current drug plan meets the criteria of a Creditable or Non-Creditable plan. If you need assistance in making that determination you may also contact our office. 

UPDATE on 1% Premium Tax—Rate Calculation change 

On September 18^th, 2009 the Oregon insurance division issued another bulletin that replaced the original bill that was signed in August to assess the 1% premium tax.  The new bulletin changes the way that the premium tax is calculated and implemented.  We are hearing that all the insurance  companies (except for Regence),  have calculated this incorrectly and they will be correcting it on your November 1^st billing.  Please call our office if you have any questions regarding this change. 

Health Care Reform 

It seems that we can’t open a newspaper, watch the news or have a conversation with friends without discussing the current Health Care Reform efforts.  There is a lot of press and talk about what the government is proposing and it can all be very confusing.  There is talk of mandated coverage, fines, coverage for everyone, a public option, affordability, increasing taxes to pay for the reform….and the list goes on and on.  We encourage you to read as much as you can and stay informed, as the proposals and issues change daily.  We will be sure to update you with any changes that will affect your coverage as they occur.     

Group Profile Forms 

Every year, your carrier sends you a Oregon Standardized Group Profile Form that they are required by the State of Oregon to mail out to mainly verify your employer size and they also ask for some additional items.  The carriers will NOT release the renewal without this information and will in some instances, either terminate your plan or inflate the rate increase unnecessarily.  Please contact your agent here in the office, if you need assistance in filling this form out.  It is very important that it is completed timely and correctly and we are more than happy to assist you!  

Flu Shot Season 

We are right in the middle of flu season….so we would like to remind you and your employees to go get a flu shot.  This is an important preventive action that we all can take to prevent the spread of this virus.  Please access your carrier website, or call customer service to find out your coverage for flu shots.  Most of the carriers will cover the flu shot for your doctor visit copay, and some are free.    The H1N1 vaccine is also coming in and being available and most carriers are covering the vaccine for the at risk (young children, pregnant women, elderly) for the same benefit as the regular flu shot.  You can also call our office and we can help you determine your coverage.   

Helpful Information from the Department of Consumer & Business Services 

In July 2009 the DCBS issued a NEWS RELEASE  that lists resources from each of the major carriers here in Oregon to help health care consumers find out in advance what the cost of their care will be. 

If you would like a copy, please contact a member of our team.  

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Employee Benefits Department Contacts: 

Suzie Moll, Employee Benefits Manager                     503-655-6344    ext 33

Stephanie Bartrug, Employee Benefits Specialist     503-655-6344    ext 29

Robert Rivenburgh, Employee Benefits Specialist   503-655-6344    ext 32

Lisa Ewers, Office Support, Individual/Medicare   503-655-6344    ext 31

Install a working smoke alarm on every level of the home, outside the sleeping areas and inside bedrooms.

Replace smoke alarm batteries at least annually, such as when resetting clocks in the fall or spring.

Test all smoke alarms in your house once a month.

Do not place a smoke alarm too close to a kitchen appliance or fireplace, as this may result in nuisance alarms.

Avoid locating alarms near bathrooms, heating appliances, windows or ceiling fans.

Replace smoke alarms that are more than 10 years old.  Smoke alarms don’t last forever.

Develop and practice a fire escape plan, because working smoke alarms and a fire escape plan increases your protection in case of a fire.