Ohio Leadership on Target for Economic Development

Gov. Kasich made a tough decision, which was also the right decision for Ohio business. Expanding Medicaid may seem like an expansion of an all ready over-reaching federal government, but the money was there and allocated. By expanding Medicaid, the Governor allowed the working poor to get healthcare coverage. Now, here is the bonus. The people covered under the expanded Medicaid roles will be exempted from employer mandates. Neither will this group of Ohio citizens count towards employer FTE measurement under ACA.

This is a very good outcome for Ohio businesses and Ohio working poor, as most would not have been able to afford their portion of employer based group coverage. The expansion of Medicaid extends coverage to the working poor, reduces the financial obligation on small and medium size business in Ohio and helps to prevent the fines and penalties against business that will be leverage by the IRS, DOL and HHS.

No State Run Exchange

Good for Ohio! Keeping the State government out of this political hot potato is an indication of Ohio leadership staying out of the way of the marketplace. The marketplace will deliver more opportunity and creative solutions for healthcare coverage because Ohio has not set itself up to be in competition with alternatives and the best creative thinking the marketplace can deliver.

Everyone should understand that the Federal government is not in charge of healthcare regulation. Each state controls the operation of health insurance providers in the state. Each state has separate rules and coverage mandates.

Just imagine, if somehow the state of Ohio had a vested interest via a monetary commitment in healthcare delivery, while the state government is also in charge of regulatory oversight of all insurance solutions.....The ODI could have been acting with more authority than Czar Barack now thinks he has over healthcare law.

Need talent to help us growth

In order to satisfy our growth, we need to add talented folks to compliment Sequent's consulting department.  Exciting challenges for an entrepreneurial-minded person that enjoys fast thinking, building a core department from scratch and helping clients achieve their business objectives. 

Sequent is seeking a Recruiting Specialist that understands the retail-mindset and has a good network to attract Change Management consultants and thought leaders. 

The Recruiting Specialist will have full responsibility to build the structure needed, grow our network of consultants and clients, manage resource allocation for various projects andwork with department leaders to ensure the resources match the client’s needs AND culture.

Sequent wants to add a Human Resource Management System consultant.  This position reports to the Technology Practice Manager and manages HRMS consulting and implementation projects.  This position is responsible for business process improvement, data flow mapping, and project management. 

The HRMS consultant serves as the main point of contact on projects and works with other subject matter experts to ensure data integrity, testing, reporting, and process improvement opportunities.  He or she identifies training needs of end users and assists in the development of training to meet those needs.  The HRMS consultant is the primary point of contact between the IT department and the HR business process owners on all system upgrades, testing and other projects as assigned.  The right person must enjoy problem solving and have servants heart.  Travel is required in order to support these on-site clients.

Apply at http://ejob.bz/ATS/CompanyPortal.do?companyGK=18797&portalGK=1710

Carriers start to position due to ACA

This is the first, but I am sure it won't be the last statement of its kind from carriers.  Look at the italics part of this quote from United Healthcare CEO. Quote of the Day

“We have nearly 70% of our 2013 business priced and the markets have been rational in our view, competitive but better than 2012 for us. We have been very steady in our pricing discipline year-to-year, consistently adhering to and aligning to our forward view of costs. And we take measured membership losses in instances where we cannot get our price, as we did in the commercial risk markets in 2012 and expect to again in 2013. We have included the ACA insurance tax and other ACA cost factors in our 2013 rate filings. We are working effectively with our state partners through the rate approval process. As always, some have been more challenging than others. At the end of the day we must price to our cost and if we conclude that a state’s posture on commercial insurance pricing is not economically sustainable, we will have no choice but to withdraw from that market. We have not been put in that position to date.” — Stephen Hemsley, president and CEO of UnitedHealth Group, discussing UnitedHealthcare’s 2013 pricing on a Jan. 17 fourth-quarter earnings conference call.

Healthcare Reform: New Suite of Federal Taxes and Fees

The text below the dotted line has been sent from a health insurance carrier to its broker network.  This helps explain
the spiraling health insurance cost.  I wonder how much tax revenue will be created due to PPACA????

....................................................................................................................................................................................................

A new suite of taxes and fees is being assessed on health plan sponsors in 2014 based on stipulations outlined in the Affordable Care Act (ACA). This Special Broker Update is part of a series of communications about these taxes and fees and how  we will implement them.

The first fee, implemented in 2012, is the Patient-Centered Outcomes Research Institute, or PCORI, fee. Currently $0.16 for each covered member and each dependent, this fee will increase to $0.18 for each in 2014. We will continue to separately disclose this charge to fully insured groups only. Self-insured groups must pay this fee directly to the government using IRS Form 720.

Beginning January 2014, other federal fees will be imposed. We expect them to be in the following ranges:

• Reinsurance fee, approximately $5.25 per member per month
• Market share fee, between 2 percent and 3 percent of the monthly premium

Reinsurance Fee
Medical Mutual will assess and collect the reinsurance fee across all medical lines of business for all fully insured plans and self-funded groups; excluded coverage includes stop loss, dental, vision and Medicare Supplement.

Market Share Fee
Medical Mutual will assess the market share fee on all fully insured lines of business, including dental and vision, with the exception of Medicare Supplement policies. Stop-loss applicability is to be determined.

Small Employers Win With Medicaid Expansion

The idea of an expanding federal government becomes less appealing every day.  However, I believe that the expansion of Medicaid to Ohio residents is good for small businesses.  We can debate the progressive or conservative position all day long, but that accomplishes nothing. 

Isn’t this really an economic development issue?  Absolutely! 

Why?

·       Increase cash into the state economic flow of over $13 BIL a year

·       Increase sales tax revenue to Ohio of $400 MIL a year

·       600,000 people will be covered by Medicaid that were not covered before

·       600,000 working people that still may be below 138% of the federal poverty level will qualify for Medicaid

·       600,000 working poor now covered under Medicaid will be EXEMPTED from employer based health care cost!

Do you understand that last point?  Seriously, this is a big deal.  The group of working poor now covered under Medicaid will not count against FTE calculations or the penalty structure under ACA.

Read this Washington Post article

http://wapo.st/11WEwlN

The healthcare wolf is at the door!

The consequences of Obamacare are beginning to take shape and the sheep's clothing is being shed to reveal the wolf inside.

The Internal Revenue Service on Friday unveiled its proposal to raise billions of dollars through annual fees on health insurers, a “$100 billion health insurance tax rule” that the industry says will significantly drive up costs for consumers.

The rule as part of the Patient Protection and Affordable Care Act imposes annual fees on health insurers that start at $8 billion in 2014, increases to $14.3 billion in 2018, and will increase every year after that. The Joint Committee on Taxation estimates the tax will exceed $100 billion over the next ten years.

The proposed rule will be published Monday for public consideration in the Federal Register. The IRS will accept comments for 90 days, beginning Monday.

Not paying on time will result in a $10,000 penalty for insurers, plus $1,000 for every day they miss deadline.

America’s Health Insurance Plans blasted the rule as a tax that will financially drown both employers and consumers. They warn that the costs will have to be passed along to consumers in the form of higher premiums, a claim that the Congressional Budget Office has also verified in its analysis.

“Imposing a new sales tax on health insurance will add a financial burden on families and employers at a time when they can least afford it,” AHIP President and CEO Karen Ignagni said Friday. “This tax alone will mean that next year an individual purchasing coverage on his or her own will pay $110 in higher premiums, small businesses will pay an additional $360 for each family they cover, seniors enrolled in Medicare Advantage will face $220 in reduced benefits and higher out-of-pocket costs, and state Medicaid managed care plans will incur an additional $80 in costs for each person enrolled.”

There is currently legislation to repeal the fees, recently introduced by Reps. Charles Boustany, R-La., and Jim Matheson, D-Utah, which AHIP strongly supports.

A 2011 report by Oliver Wyman found that nationally the health insurance tax alone “will increase premiums in the insured market on average by 1.9 percent to 2.3 percent in 2014,” and by 2023 “will increase premiums 2.8 percent to 3.7 percent.”

Families purchasing coverage in the individual market will be hit the hardest in New York while those getting coverage from a small employer will be most impacted in West Virginia, Oliver Wyman analysis also found. Medicare Advantage beneficiaries in New Jersey and the Medicaid managed care program in Washington, DC top their respective lists of those that will be hardest hit by the tax.

This is taken from an Employee Benefits Bulletin

Be ready for a big shock from Healthcare Deformity

As the realities of ACA become clear, the impact on employers will be staggering in two ways:

Increase cost of premiums.  There is nothing in ACA that helps to reduce the overall cost to employers or to employees.  In fact, we believe that employee-only premium will be an average of $600 per month with dramatic increases to young and healthy individuals.  The least expensive option available under ACA is the Bronze plan, which could be $20,000 per year for a family.

Daunting record keeping. An employer with over 50 FTEs will be required to monitor which employees are eligible to participate in the health insurance offering.  Aggregating all hours worked to calculate FTEs (full time equivalents) and establishing a look-back period for the monitoring of the same will require the need to be able to get data from your HRMS system for documenting this process.

More good news for small companies
Even though a company with less than 50 FTEs is exempted from the law, all companies regardless of size will be subject to the premium increases due to mandated plan designs of ACA.  And don't think you can escape being a plan sponsor if you decide one of the exchanges is right for you.  Securing health insurance through an exchange creates a whole new set of requirements for plan documents and disclosures.

Yet to be determined
ACA will evolve over the next year even more.  There are about 1800 rules yet-to-be-written by more government appointees.  So, hold on to your belt and tie your shoes tight!

What do I need to do if we offer a health insurance plan?

Does this sound like you?

My company has grown over the years with a number of employees. To help keep employees happy and attract the right kind of new employees, my company provides health insurance for everyone.  

We have worked with an agent for a long time who shops our health insurance plan every year.  The agent provides some services to us and works gives us quotes from different health insurance providers. Does my agent do these things? 

Use this checklist to make sure you are doing what you need to do.

             

Plan administrative tasks	Who is performing task?	Who has liability?
Monitor when a new employee becomes eligible to participate in the plan?
Conduct new hire health plan orientation and educate new hires on the basics of the plan selected?
Secure the benefit election forms?
Answer questions from employees or their covered dependents about the benefits?
Assist the covered employees and their dependents with benefit/coverage problems?
Help employees understand the Explanation of Benefits (EOB) or other communications or questions they may receive from the carrier?
Assist employees with locating network providers?
Assist employees with accessing medical websites?
Order ID cards if employee misplaces them?
Communicate and/or provide election information to payroll so the proper payroll deductions can be made?
Update the deductions if rates for the plan are based on age when an employee falls into a new rate band and the premium increases?
Review the accuracy of the bills from the insurance company every month?
Add and delete employees from the insurance provider bill?
Pay the invoice from the insurance company?
Audit payroll reports to make sure the proper deductions are being taken from the employees’ pay?
Administer the HSA and/or FSA accounts and make fund transfers to the employees’ accounts?
Update the Summary Plan Description annually and completing the IRS 5500 form?
Send out the required ERISA and state notifications to plan participants?
Manage the open enrollment process?
Perform COBRA administration (if applicable) or prepare & send State continuation of coverage notices to the ex-employee?
Protect employees’ rights under the Privacy Act and HIPAA?
Prepares a standard plan document for all coverage (this is not the insurance contract)
Works with outside legal to help be compliant
Segment health insurance records and keep in secure location
Trustee on the plan and what does it mean to be a plan trustee
Protects employee confidentiality under “need to know” principals
Employee benefit E & O coverage and cost

The Difference Between Engagement and Satisfaction

Employee Engagement doesn't equal Satisfaction

Engaged people are happier and happier people produce 40%+ more revenue than disengaged employees. (Hay Group)

In today's rapid-fire environment, it seems really hard to help employees get a clear understanding of what is expected of them in their jobs.  As soon as one group learns the "new" thing, another new thing is right around the corner ready to pounce on their old ideas.  Change creates discomfort because people love predictability, but the market drivers are moving faster than ever before.

Do employees embrace the values, vision and mission of the organization, even while change is coming? 

The employees that are positively connected within the organization both through their supervisor/leadership and others in the organization are the ones that lead the change because of their passion for the job.  They know that their work makes a difference in the organization; and therefore this group is able to see a future for themselves in the organization.

Sounds like everyone is holding hands and singing...right?  But the other 80% of employees may not feel the same way. One thing is sure, if employees are not engaged there will be dissatisfaction between what you want and what you've got! 


http://www.sequent.biz/UserUploads/Consulting%20Services/EE-Engagement_Assessment_SS_05-16-10.pdf