by Medcon Benefit Systems Group, Inc.

The Future of HSAs and Consumer-Driven Plans

Do you understand the new HHS guidelines on actuarial value, or how the minimum medical loss ratio regulations impact your business? if you now have or are considering implementation of an HSA or HRA, you won’t want to miss this 90 minute webinar conducted by the Healthcare Choice Coalition to find out what the future holds for these plans. Hear HSA expert Roy Ramthun, and actuarial expert Mac McCarthy explain the new HHS bulletin and review the final regulations on “minimum medical loss ratios”. You will gain practical, insightful, high quality information to help you understand the new requirements create challenges and what you can do in response.

Choose from one of three options to hear the webinar live:

Tuesday, March 13, 2012

11:00 am – 12:30 pm ET (8:00 am – 9:30 am PT)

Wednesday, March 21, 2012

12:00 pm – 1:30 pm ET (9:00 am – 10:30 am PT)

Thursday, March 29, 2012

11:00 am – 12:30 pm ET (8:00 am – 9:30 am PT)

Cost: $50 (FREE For Healthcare Choice Coalition Members)

 

To register and find more information, please visit:

http://www.healthcarechoicecoalition.org/join-now.html.

by Medcon Benefit Systems Group, Inc.

Summary of Benefits and Uniform Glossary Regulations

On Februray 9, 2012, final regulations were released regarding the Summary of Benefits and Coverage (SBC) and Uniform Glossary requirements for health insurance plans. The goal is to provide consumers with simple information on plan coverage and help consumers better understand the coverage they have in order to compare differences in benefits and coverages when they are shopping for a new plan.

Beginning on the first day of the first open enrollment period that begins on or after September 23, 2012, plans must provide the SBC to participants and beneficiaries who enroll or re-enroll for coverage during the open enrollment period. Additionally, an SBC must be provided to all participants and beneficiaries who do not enroll during an open enrollment period, including newly eligible individuals and special enrollees, on the first day of the first plan year that begins on or after September 23, 2012.

An SBC must be provided as either a stand alone document or in combination with other summary materials, but it must be prominently displayed at the beginning of the document. A template of the SBC is available for use here from the U.S. Department of Labor, in addition to the Uniform Glossary. Groups are also required to provide participants and beneficiaries who reside in a county where 10% or more of the population is literate in the same non-English language, a copy of the SBC and Uniform Glossary in the non-English language. The Department of Health and Human Services has agreed to provide written translations of the SBC template to comply with this requirement and post on their website.

Be sure to visit the U.S. Department of Labor Health Reform website for full details and instructions regarding the latest SBC regulations, and as always, feel free to contact us at MedCon Benefit Systems with any questions.

by Medcon Benefit Systems Group, Inc.

Independent Contractors?

If your company uses the services of independent contractors the feds may want to talk with YOU soon! The IRS has recently started a new enforcement strategy to identify independent contractors that should actually be classified as employees.

The new project is set to recoup those payroll taxes on independent contractors as well as penalties and interest. It is expected to raise $7 billion in tax revenue in the next decade. They are targeting industries where they believe employers most commonly misclassify workers.

At the top of the list are: construction related companies, child care, home health care and grocery stores.

If you have questions or concerns about your classifications feel free to contact us, we are happy to help!

by Medcon Benefit Systems Group, Inc.

Confused About The W-2 Reporting Guidelines?

On January 3, 2012, the IRS released additional guidance for employers regarding the W-2 health benefits cost reporting. Questions previously voiced about voluntary benefits and how they fit have been answered:

Q&A number 37 in IRS Notice 2012-9 explains:

Only when employers make some contribution to the cost of coverage, or employees purchase coverage on a pre-tax basis under a Section 125 cafeteria plan, will employers have to include the value of supplemental health benefits, such as hospital indemnity, critical illness, cancer or other specified disease insurance, in their W-2 reporting.

Employers do not have to include the cost of supplemental health benefits that the employees pay entirely with after-tax dollars, according to the notice.

What Must You Report?

  • Medical plans
  • Medicare supplemental policies
  • Prescription drug plans
  • Dental or vision plans that are integrated into a group health plan so that they are part of the same insurance policy, contract or certificate of insurance.

It will be reported in Box 12 under Code DD. In general, the W-2 reporting requirements mean employers will need to explain the benefits reporting employees see on their W-2s, so employees understand they are not being taxed on their benefits coverage.

*This is informational only, it does not cover all the guidance, issues and requirements surrounding the W-2 health plan cost reporting, nor does it constitute legal or accounting advice.
by Medcon Benefit Systems Group, Inc.

Maximize Your FSA Before 2012

As the year end approaches, we want to offer some suggestions to you about how to effectively utilize the funds still remaining in your flexible spending account, or FSA. Unlike a health savings account, the funds in your FSA cannot be carried over to the next plan year, so it is best to use them before your current plan year expires.

1. There is a substantial list of eligible expenses that can be purchased with your FSA, or that could potentially qualify for reimbursement if you have already purchased these items. Please note, this is a sample of common items and is not a complete list. Please check with your FSA provider first for a complete list of eligible expenses.

  • Acne Treatment Proactive, Stidrex, Clean & Clear Eligible
  • Acupuncture
  • Ambulance
  • Bandages Elastic, Gauze Pads, Band Aids
  • Birth Control Pills
  • Birthing Classes
  • Blood Pressure Monitoring Devices
  • Carpal Tunnel Wrist Supports
  • Chiropractors
  • Co-Insurance Amounts
  • Contact Lenses, Materials & Equipment
  • Contraceptives
  • Co-Payments
  • Crowns, Dental
  • Crutches
  • Deductibles
  • Dental Care Toothache Relief, Temporary Filling, Denture Adhesives
  • Diabetic Supplies
  • Ear Care, Ear Drops, Ear Wax Removal
  • Egg Donor Fees
  • Eye Examinations
  • Fertility Treatments
  • Adhesive Pads, Band-Aids
  • First Aid Kits
  • Flu Shots
  • Gambling Problem Treatment
  • Genetic Testing
  • Guide Dog: Other Aid Animals
  • Hearing Aids & Its Batteries
  • Immunizations
  • Infertility Treatments
  • Insulin
  • Laser Eye Surgery LASIK
  • Medical Alert Bracelet or Necklace
  • Medical Records Charges
  • Mileage for Medical Appointment Expenses for Transportation Primarily for & Essential to Medical Care
  • Nasal Strips or Sprays
  • Nicotine Gum or Patches Nicoderm, Nicorrett Eligible
  • Occlusal Guards to Prevent Teeth Grinding
  • Oxygen
  • Sleep Aids Tylenol PM, Sominex, Unisom
  • Smoking Cessation Medications Patches, Gums
  • Stomach/Digestive Relief Pepto-Bismol, Imodium, Colace, Lactaid
  • Tooth & Mouth Pain Relief Oragel, Anbesol
  • Vitamins
  • Walkers
  • Wheelchair
  • X-ray Fees

2. If you have any receipts for health care related expenses or dependent care related expenses, be sure to submit them as soon as possible in order to be reimbursed. This will help you verify how much you have left in you FSA account.

3. If you regularly purchase medical supplies that are eligible to purchase with your FSA, you can stock up on them before your plan year expires with your leftover funds.

4. Make sure you and your family members are caught up on all doctor appointments. Your FSA funds can often be used toward your co-pay and coinsurance at your physician, dentist and optometrist, as well as some specialty doctors as long as they are listed on your eligible expenses list.

5. Make sure you and your family members are up to date on your vaccinations, including the flu shot.

6. As always, keeping up with your wellness is an essential step to keeping your medical expenses to a minimum. Weight loss counseling and methods to help you quit smoking are eligible expenses for your FSA, as long as you have a doctor’s note of medical necessity.

If you have questions about any of these items, please feel free to contact your health care experts at MedCon Benefit Systems Group, Inc. (214)739-5215.

by Medcon Benefit Systems Group, Inc.

Maximize Your Employee Benefits Program

With the economic recovery continuing to be slow and companies under pressure to overcome a number of challenges, the employee benefits landscape is continuing to change. Rising healthcare costs, new mandates of reform and economic influences are just some of the reasons employees are looking for solutions for the highest potential return on investment. Here are some tips from our benefit professionals on how to maximize your investments.
1. Work with a benefits  consultant / advisor who can help you design a “healthcare reform” strategy that includes a consumer directed approach with financial protection.
2. Get the best overall value and experience by partnering with those who can provide expertise and experience in delivering both self funded and employer funded benefits as well as voluntary benefits.
3. Engage your consultant to maximize the value of your benefits by meeting the financial protection needs of your various workforce diversities. Offer a range of benefit choices and include effective benefits education for your employees.
4. Optimize your ROI with helpful services such as employee assistance programs, helpful management of absences from FMLA and various state laws to streamlining HR time with benefits administration and technology solutions. Consider outsourcing services to our sister company, Employee Resource Administration, to help with all of your non-revenue producing functions.
by Medcon Benefit Systems Group, Inc.

Unum Survey Reveals “Caring Culture, Better Benefits Are More Important Than High Pay”

Unum recently commissioned research from Charles River Associations. The report quantified the economic and social value of the financial benefits provided by many of our clients.

As cited in the study, access to group disability benefits protects as many as 500,000 families a year from impoverishment. It translates into direct savings of up to $4.5 billion a year to the government and ultimately to you, the tax payer. The study also showed that every dollar spent by employers on programs such as disability, life, long term care, critical illness and accident, returned a significantly larger economic value to workers who receive them.

As the government faces continued budget challenges it becomes clear public dollars will not be available to provide resources. As a result, the workplace will become an even more important delivery system for benefit options that offer types of financial stability.

As the research concluded, currently nearly 70% of the working population does not have access to disability at work. With 30+ years in the disability marketplace we are happy to help you begin discussions about how to give your employees access to those valuable coverages.

by Medcon Benefit Systems Group, Inc.

Comparison Shopping For Medical Care

Have you ever wondered what it would be like if you could comparison shop for your medical costs?  When you go to buy a car, you spend $20,000 or $30,000, maybe even over $40,000.  The likelihood of you walking into the dealership and paying sticker without any questions is slim to nil. Yet, millions of Americans do just that with their healthcare every year.  Have you ever asked, “how much is the surgery going to cost?” or “how much exactly is the cat scan?”  Yet, these are procedures that can potentially cost upwards of tens of thousands of dollars and we have them performed at the directive of our physicians with no questions asked.
Once you have selected your insurance carrier and designed  your health plan, you hope the strength of the design is enough to deter over  utilization.  Employees are deciding where to go for treatment and surgery blindly.  Are they making the choice based on the cost to the employer’s insurance plan?  The answer is: not likely.  Consumers of health care services are not like most other consumers.  Employees do not, and in the past could not, compare prices before they bought.  In the past you could not find out a price for a diagnostic colonoscopy or a tonsilitomy.  Again, compare that decision to that of buying a car.
What if we could add to your program a service that allowed your employees to find out exactly what that cost would be up front?  Not only with one provider, but let’s say up to three?  How about if they compared three and then proceeded to schedule the appointment for your employees.  Imagine the time and money that could be saved.
If this is something of interest to you and your employees, contact us! We have the answers.
MedCon Benefit Systems Group, Inc.
214.739.5215
by Medcon Benefit Systems Group, Inc.

Self Funding – Act II

Having been in the insurance industry for over 25 years, collectively our agency specializes in “self funding.”  It is with great pleasure that we welcome the resurgence of this funding instrument back to center stage.

Self funding gives the employers back the control — the control over both plan design and the financing of their health care benefit plan.  While the employer assumes the risk of expected claims, you will purchase insurance (stop loss coverage, both specific and aggregate) to protect your plan against unpredictable or catastrophic claims.

The financial control is gained by paying for only the claims that your employees incur, when they incur them.  In a fully insured environment you pay a monthly premium up front for what the insurance company believes your claims are going to be, advance premium payments.  This also translates to the insurance company holding/investing your money.

By funding your own claims, you are also avoiding the costs of claim reserves as well as premium taxes.  Included in these charges are the insurance company’s profit margins, risk charges, and their administrative fees.  There will be administrative fees associated with your  self funded plan but typically much lower than those of a fully insured plan.

The self-funded vehicle allows the employer to design the health benefit plan to meet their specific needs.  It offers the flexibility to manage costs and make changes to better manage utilization and take advantage of discounts offered through third party vendors.  All of which can help in the making of a much more cost effective plan.

We will be discussing the advantages  of self funding in more detail in future blog posts.  Should you have a questions please feel free to contact Sharon McReynolds at 214/739-5212 or email smcreynolds@medconbenefit.com.