United Concordia Introduces Online Individual Dental Plans

  United Concordia has rolled out the iDental platform! With iDental individuals and families can enroll on a dental plan who do not have coverage through their employer. There are five plan options to choose from and annual maximum benefits as high as $1500 per family. Best of all, you can quote and enroll the coverage instantly online. Click here to get a free dental plan quote!

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Update on Exchange Notice Requirement for All Employers

Most employers must provide their employees with written notice that includes information regarding the Exchange (now called the Health Insurance Marketplace). The deadline to provide the notice is approaching; the notice must be provided to each employee not later than October 1, 2013. Employers are free to move forward with providing this notice, but may want to wait until closer to the deadline (perhaps early-mid September) in the event additional guidance is issued or the Exchanges are further delayed.  Click the link below to download the notice. Exchange Notice Reminder – 82113R

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New Tool Provides Guidance on Health Care Changes

A new interactive “wizard tool” is available online from BusinessUSA to help employers understand the changes that may affect their companies under Health Care Reform. The tool is simple to use. Business owners can input information regarding company size, location, and whether they currently offer insurance to their employees. Based on the employer’s responses, the tool generates guidance on Health Care Reform changes and other health care-related resources relevant to the employer’s business. Other useful information and services for business owners can be found on theBusinessUSA website.

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Free Series for Small Business Owners to Help Understand the Law

Free Series for Small Business Owners to Help Understand the Law   The U.S. Small Business Administration (SBA), together with the Small Business Majority (a national nonprofit advocacy organization), has launched theAffordable Care Act 101 Weekly Webinar Series. The webinars feature guidance on key pieces of the law for small business owners provided by SBA representatives, followed by a question and answer period.   Topics being discussed in the webinars include:   Small business tax credits—who is eligible and how to claim the credit; Shared responsibility (also known as “pay or play”); Cost containment; and Tools and resources available for small businesses to learn more about the law.   The… Read More

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Final Guidance on Contraceptive Coverage Released

The Affordable Care Act requires non-grandfathered group health plans to cover certain preventive services without cost-sharing. Effective for the first plan year that began on or after August 1, 2012, this requirement includes coverage of all FDA-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity, as prescribed by a health care provider. The Departments of Labor, Treasury and Health and Human Services issued a final rule addressing the contraceptives mandate for religious employers and nonprofit religious organizations, discussed briefly below. Generally speaking, the final rule follows the proposed rule, with a few modifications.   Click here to download the final details on Contraceptive… Read More

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Limit on Consumer Costs Is Delayed in Health Care Law

WASHINGTON — In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care. The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014. The grace period has been outlined on the Labor Department’s Web site since February, but was obscured… Read More

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New Tool Provides Guidance on Health Care Changes

New Tool Provides Guidance on Health Care Changes   A new interactive “wizard tool” is available online from BusinessUSA to help employers understand the changes that may affect their companies under Health Care Reform.   The tool is simple to use. Business owners can input information regarding company size, location, and whether they currently offer insurance to their employees. Based on the employer’s responses, the tool generates guidance on Health Care Reform changes and other health care-related resources relevant to the employer’s business.   Other useful information and services for business owners can be found on the BusinessUSA website.

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What’s up with Medicare these days?

Let’s face it, even though Medicare provides health coverage for 49 million Americans, the program itself isn’t all that easy to understand. That’s why AARP Illinois State President Merri Dee and AARP Illinois staff member and Medicare expert Courtney Hedderman got together this week for a question-and-answer session with about 1,500 of our members through a tele-town hall. Here are some of the questions asked during the call and the answers. Q: I’ve heard that the new health care law makes changes to Medicare, can you explain those changes? Click here for the story on the AARP Medicare Blog

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New notice explains effect of employer mandate changes

The employer penalty provisions and two reporting requirements under the Affordable Care Act have been delayed until 2015. Although Notice 2013-45 was released, it does little to expand on the earlier announcement of the delay. The Notice does provide further guidance on the transition relief that operates to delay these provisions. It is important to note that the employer penalties and applicable reporting requirements will be fully effective in 2015. The Notice confirms the following: Click to download and read

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How the ACA Helps Medicare’s Disabled Beneficiaries

  The Affordable Care Act, which was passed in 2010 and upheld by the U.S. Supreme Court in 2012, includes numerous provisions that impact people with disabilities through expansions of Medicaid, private health insurance reforms, new care coordination programs and efforts to transition elderly and disabled populations from institutional to home and community settings. The ACA: Click here for the story on Medicare News Group

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IBC: Important change to claims processing for PPO plans

Independence Blue Cross (IBC) will begin notifying customers later this week regarding a change in how claims for certain out-of-network providers will be processed under their IBC Personal Choice® PPO health plan. This change impacts fully insured, self-funded, and Individual commercial Personal Choice® PPO plans only. There is no impact to Medicare plans. Effective November 1, 2013, members who have claims submitted by providers who participate in the Highmark Blue Shield (Highmark) professional provider network inside IBC’s five-county service area will be subject to higher out-of-pocket costs and may also be subject to balance billing. Currently, claims submitted by a participating Highmark professional provider are processed as out of network and applied… Read More

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Health Reform: Research Filing Fees Due July 31

The Research Fee filing deadline is July 31, 2013 for self-funded medical plans and HRAs  Insurance carriers will report and pay the Fee for fully insured plans.  If an employer has several self-insured arrangements with the same plan year, they are subject to a single fee.  An HRA integrated with a self-funded plan providing major medical coverage will not incur a separate fee specific to the HRA if the HRA and plan are established or maintained by the same plan sponsor.  Click below to download the bulletin   Research Fees Due    Interested in our free Health Care Reform Checklist? send an email  

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NJDOBI Issues Amendments to Rating Rules under PPACA

NJDOBI Issues Amendments to IHC and SEH Rating Rules under PPACA For rates applicable to all rating periods beginning on or after January 1, 2014, carriers are directed to: Formulate rates in the IHC market to achieve a required 300 percent maximum ratio between premiums for the highest rated individual policyholder and the lowest rated individual policyholder in the State. Age factor categories should be in the following increments: children ages 0 through 20, one-year age bands for adults ages 21 through 63, and a single age band for adults ages 64 and over; Formulate rates in the SEH market without regard to gender. Age factor categories should be in… Read More

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Healtcare Reform Law

Health Insurance Marketplaces (Exchanges): Informational Video

Beginning in 2014, individuals and small businesses with up to 50 employees can purchase insurance through online exchanges, also called “health insurance marketplaces.” Each exchange will offer a choice of health plans that meet certain benefit and cost standards. In 2016, businesses with up to 100 employees will be able to participate. Coventry Health/Aetna recently released this easy to understand video that may help you understand the new exchange or” marketplace” system of buying health insurance. Click here to watch the six minute long video.

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Medicare: What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)?

Q:What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)? A: Business income has increased for doctors because many people on Medicare are now using free screenings and an annual “wellness visit” provided through the Affordable Care Act (ACA). Through Oct. 6, 2011, the government said, 20.5 million people enrolled in Medicare had received the free screenings or the annual visit, which is also free. Medicare is now offering a 10 percent bonus payment on the fees charged for primary care services, and a 10 percent bonus payment to surgeons who work in areas where there are shortages of doctors. For 2013 and 2014, Medicaid payments… Read More

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