 We're Hosting a Greeley Chamber of Commerce Business After Hours! Mark your calendars for Thursday, November 15 from 5-7pm for our 1st ever Business After Hours event! | |
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2012 Shirazi Benefits Holiday Calendar
Listed below you will find a list of observed holidays in which our office will be closed in 2012.
Early closings surrounding these holidays are not predetermined; however, as a holiday nears, we will notify our clients in advance of any early closings.
July 4th, 2012:
Independence Day
September 3, 2012:
Labor Day
November 22-23, 2012:
Thanksgiving
December 25, 2012:
Christmas Day
January 1, 2013:
New Year's Day
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 Subscribe to our "Step Into Wellness" Newsletter! With resources on how to implement a wellness program, completing the HERO scorecard, a testimonial from a current client who has successfully implemented a wellness program, getting your employees to know their numbers, a compliance checker and much more! | |
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Open Enrollment for Child-Only Policies
The next open enrollment for child-only policies is almost here, so we've compiled some helpful information in terms of what policies are available and what parents should expect when submitting child-only applications next month.
The next open enrollment period is July 1-31 for a September 1 effective date. This is the last open enrollment period in 2012. Applications for the policy must be submitted prior to July 31st.
All eligible child-only applications submitted during the open enrollment period are guaranteed issue, so the child cannot be refused coverage. However, the applications are still medically underwritten and the rate can be increased by up to 300% based on the child's medical history.
This makes child-only policies in the first two years especially very expensive and in some cases, almost double the quoted premium. Typically, during the first two years of a child's life, more immunizations are required and children cannot communicate effectively during this time, so parents over-utilize the doctor.
Rocky Mountain Health Plans offers all of their SOLO individual policies for child-only policies.
Or, contact Allie Perkins in our office at 970.584.1719 or aperkins@shirazibenefits.com for additional details.
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IRS Guidance on the $2,500 FSA Cap
Recently, the IRS released an update regarding the $2,500 cap for Health FSAs in IRS Notice 2012-40. The following is a highlight of the notice:
The term "tax year" is defined to mean the "plan year". All plan years beginning after 12/31/2012 will be subject to the $2,500 cap.
Plans that begin in 2012 and carryover into 2013 can continue to have an unlimited Health FSA maximum.
The $2,500 maximum applies only to the Health FSA and not other plans such as premiums, dependent care, adoption assistance, etc.
For short plan years beginning after 2012, the $2,500 limit must be prorated based on the number of months in the short plan year.
The 2 1/2 month grace period can continue to be in place and any carryover balances will not impact the next year's $2,500 cap.
Spouses who participate in the plan are each allowed to enroll at the $2,500 maximum, even if they work for the same company.
Amendments to plan documents are required to make the applicable changes before the start of the next plan year in 2013. Current clients will receive information about updating their document prior to their 2013 renewal.
The IRS is also requesting feedback on potential changes to the use-it or lose-it rule.
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50% of Americans Are Not Contributing to 401(k), IRAs
By Marli D. Riggs
 "Half of Americans say they aren't contributing to a retirement plan, but more specifically 56% of Americans ages 18-34 are more likely to be among those not saving, according to a recent LIMRA survey.
A quarter of all Americans and less than a third of Americans older than age 50 work with a financial professional to plan for retirement. However, those who do are more likely to be contributing to a defined contribution plan or IRA."
Click here to read the entire article. If you feel your contribution plan is being under-utilized by your employees or feel this is an important benefit that your benefit package is lacking, please contact our office.
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HHS Issues Final Rules on MLR Notices for Those Not Receiving Rebates
Beginning this year, insurers and HMOs must provide annual rebates to policyholders if their MLR (percent of premium spent on claims/ medical care) is less than 85 percent for large groups and 80 percent for small groups or individuals.
Rebate checks and notices to those receiving a rebate must be sent by August 1, 2012. There was an open question about whether notices would need to be sent to those not receiving rebates.
The notice to those not receiving rebates is required only for the 2011 rebates that will be issued in 2012. The purpose of sending it this year is to help educate consumers about MLR and direct them to the www.HealthCare.gov website for MLR information.
The notice must be provided with the first plan document (for example, open enrollment material) that is provided to enrollees on or after July 1, 2012. It may also be provided electronically.
This notice is not required for expatriate or mini-med policies where no rebate is due. In addition, for groups of policies with fewer than 1,000 participants where there is not enough credible data to determine if the MLR standard has been met, this notice is not required.
A copy of the new notice (Notice #4) is available at http://cciio.cms.gov/resources/other/index.html#mlr
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 The New Normal in Health Insurance: High Deductibles By Jay Hancock
"Seventy percent of large companies recently surveyed by Towers Watson said they'll offer high-deductible insurance by 2013 combined with accounts that let patients buy medical services with pretax dollars, often funded by the employer. Nearly a fifth of the firms responding to the survey, conducted by Towers and the National Business Group on Health, a nonprofit alliance of large companies, said high-deductible coverage would be the only option in 2013.
Big companies that have shifted all or most employees to high-deductible coverage include financial firms Wells Fargo and American Express and grocer Whole Foods. All U.S. workers at building materials giant Saint-Gobain will be on a high-deductible plan starting next year, benefits manager Natasha Romulus said.
Among high-deductible plans' advantages: For both companies and workers, premiums are substantially lower than for traditional coverage. Employers often use money saved on premiums to fund tax-free health savings accounts and similar arrangements to help workers pay for deductibles.
Even before the Affordable Care Act required all plans to pay for preventive care, high-deductible insurance typically covered 100 percent of the cost of physicals and screenings, benefits experts say. Like many companies, GE contributes company money to the tax-free accounts - $500 for individuals, $1,000 for families - for employees to pay some of the deductible.
The idea is for people to receive the preventive care they need and seek lower-cost treatment when they get sick, knowing their money is first in line to be spent."
Read the full article here. |
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Rocky Mountain Health Plans
Benefit Enhancements
Effective August 1, 2012, RMHP will provide 100% in-network coverage for the following preventive services for women. All group and individual plans will include these benefits, regardless of Grandfathered status.
Breastfeeding: Comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies for pregnant and nursing women.
- RMHP will provide 100% in-network coverage for the rental or purchase of a manual or electric breast pump, up to the cost of the RMHP "preferred" breast pump. Counseling from trained providers will be covered with no office visit copay.
Gestational Diabetes screening: screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes.
- Currently covered in routine OB care. High glucose blood tests will be covered at 100%.
Domestic and interpersonal violence screening and counseling for all women.
- Currently covered in annual PCP examination at no charge.
HPV DNA testing
- Per regulation, RMHP will cover testing for women older than 30, every three years.
Sexually Transmitted Infections, Counseling; and HIV screening and counseling for sexually active women.
- Currently covered in annual PCP examination at no charge.
Well-woman visits to obtain recommended preventive services for women under age 65
- RMHP currently provides this coverage at 100%.
Contraception and contraceptive counseling for women.
- RMHP will provide 100% in-network coverage for patient education & counseling.
- RMHP will provide 100% in-network coverage for the following FDA-approved contraceptive methods:
- Generic oral contraceptives
- Injectable contraception (Depo-Provera)
- Contraceptive patch
- Emergency contraception ("Plan B" with physician Rx)
- Barrier contraception (Diaphragm with physician Rx)
- Hormonal contraception (NuvaRing with physician Rx)
- Implanted contraception
- Copper IUD
- Nexplanon Implant
- Mirena IUD
- Hysteroscopy
- Tubal ligation
- RMHP does not cover abortifacient drugs
Amendments to the plan designs will be mailed to all employer groups and Subscribers in July.
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