Shirazi Notice

March/April 2012

Shirazi Benefits was recognized in the category of businesses employing one to 10 people.

If you wish to read more about why we were chosen for the award, click here to read an article published by the Northern Colorado Business Report.

Click here to view a checklist designed to help employers who sponsor group health plans review their plan's compliance with the major provisions of Health Care Reform that may affect their company in 2012. 

The information is subject to change based on new requirements or amendments to the law. Additionally, your group plan may be exempt from certain requirements described below. If you have any questions regarding your obligations with respect to Health Care Reform, please consult with your Account Manager.

Benefit plans can be affected by life event changes, some of which qualify as an official change in status by the IRS. Generally, when you enroll in benefits as a new employee, you cannot make any changes until the next Open Enrollment period. However, if you experience a qualified change in status you can make mid-year changes.

Some examples of changes that you may make include:

• Change the number of people covered under your plans
• Enroll in or discontinue your coverage
• Begin a new / change an existing Medical or Dependent Care Flexible Spending Account

A life event change, also called a qualifying event, is a personal change in status which may allow you to change your benefit elections. Examples of some qualifying events include, but are not limited to, the following:

1. Change in legal marital status - marriage, divorce, legal separation, annulment, or death of a spouse
2. Change in number of dependents - birth, death, adoption, placement for adoption, award of legal guardianship
3. Change in employment status of the employee's spouse or employee's dependent - switching from part-time to full-time employment status or from full-time to part-time, termination or commencement of employment, a strike or lockout, commencement of or return from an unpaid leave of absence which results in employee/dependent becoming ineligible for coverage
4. Dependent satisfies or ceases to satisfy eligibility requirement - marriage of a dependent or change in student status

As the 1st quarter of 2012 wraps up, this has been a busy year for us in terms of assisting our clients with implementing and developing workplace wellness programs. As we all know, the cost of health care is not cheap. And especially for those of you that are self-insured, the cost of health care is definitely not cheap if your employees are unhealthy. Outside of the cost savings, workplace wellness programs help create a healthy workplace culture and cultivate happier, healthier and more productive employees.

This month, we've created a special newsletter called "Step Into Wellness" that will be sent directly to those clients of ours that we assist in wellness programs with, or those that are interested in wellness for their organization. If you would like to receive this newsletter, please just send Jamie an email at jdennis@shirazibenefits.com to get added to the list! 

Why Should Your Company Get Involved?

The number one cost driver in American health care is chronic diseases. More than 75 percent of all health care dollars go to buy care for patients with chronic conditions. So what behaviors cause chronic diseases? The two primary drivers for chronic conditions are obesity and inactivity. 

If you see a need for a workplace wellness program within your organization, get started by contacting Jamie Dennis in our office. We utilize the carriers we work with as well as local third-party vendors to help you create a custom workplace wellness program that is specific to your company's needs.

"...an employee unprepared for the financial impact of a large claim on a high-deductible health plan might be faced with a financial crisis even though he or she has a quality comprehensive health insurance plan in place. Even if the high-deductible health plan is appropriate, if employees don't understand the importance of opening and funding a health savings account, they'll ultimately be unhappy.

Part of the problem with the American health care delivery system is the well-documented disconnect between the actual cost of services and who pays for those services.

High-deductable health plans address this disconnect by making insured people responsible for the relatively low cost of daily health care occurrences, while protecting them from catastrophic claims. The employee wins through lower premiums and the tax advantages of opening and funding a health savings account, while the health insurance industry is betting consumerism will help to stem the escalation of medical inflation.

The luster of a high-deductible health plan quickly diminishes, however, if employees are not able to fund their deductible when a claim is incurred. They'll quickly forget their premium savings and focus instead on a perceived lack of coverage."

Does any of this sound familiar? Of course it does. However, there are steps we can take to make sure your employees are better prepared. 

1. Make sure employees open an HSA account right away and prior to incurring any claims. An HSA account must be open on the date a claim is incurred to allow payment from a health savings account.
2. Make sure the HSA allows online deposits from a checking or savings account. If it is convenient to deposit money into an account, the chances of that account being funded rise exponentially. Better yet, help employees set up direct deposit from paychecks or bank accounts to health savings accounts.
3. A third way to help plan in advance for a large claim is through critical illness coverage and accident benefits, which help offset large deductibles and increase client satisfaction. For a relatively small monthly premium, these products can provide protection from a large claim before patients have health savings account funds to meet a deductible.
   • If you currently do not offer any critical illness or accident coverage, speak with your Account Manager and our office can assist in helping you offer these benefits to your employees at no cost to you.

You can read the full article here.

The Prescription Drug List on UnitedHealthcare Advantage and Traditional plans will have updates effective July 1, 2012. 

Click here to view the updates.

Members taking select maintenance medications impacted by a change will receive a letter in June where lower cost alternatives may be listed.

As you know, insurance companies now cover preventive care services as required by the Patient Protection and Affordable Care Act (PPACA), without charging a deductible, copayment or coinsurance when these services are provided by a network provider in a primary care setting, based on your age, gender health status and benefit plan. 

These covered services are consistent with the recommendations and guidelines of the United States Preventive Services Task Force (USPSTF) or other regulatory organizations based on age, health status, gender guidelines and medical evidence.

You can click here to view the list of recommended preventive services categorized by age and gender.

2012 Department of Health and Human Services (HHS) 

Women's preventive services

On Aug. 1, 2011, HHS released new health plan coverage

rules that will require health insurance plans, including

UnitedHealthcare, to cover women's preventive services

such as well-woman visits, domestic violence screening,

and U.S. Food and Drug Administration (FDA)-approved

contraception methods, without charging a copayment,

coinsurance or a deductible for plan years beginning on or

after Aug. 1, 2012.