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Stay up to date with real-time news related to health care policy right on our homepage, brought to you by Kaiser Health News.
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 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.
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! | |
 By Len Garrison
Director of Health & Wellness at Jackson Healthcare
"If you build it they will come." Well, that may be true in some instances. But if you're talking about a wellness program, the saying should be "if you build something they like, they will come." And the only way to find out what they like is simply to ask them!
At Jackson Healthcare, we administered an employee survey designed to gather information that would let us know what types of programs our employees could get excited about. In the survey, we asked, "What are your terms of engagement?" "What kinds of programs and initiatives would you need to help you with your health and fitness goals?" How can we help you get started on your own healthy road?"
While an employee survey may seem cumbersome and time-consuming, we have helped a few of our clients develop an employee wellness survey so we could help them gather information to develop successful wellness programs that their employees are interested in! Contact Jamie in our office if you think an employee wellness survey might help you kickstart your own wellness program!
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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.
Contact Allie Perkins in our office at 970.584.1719 or aperkins@shirazibenefits.com for additional details.
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After the Ruling: A Consumer's Guide
By Mary Agnes Carey, KHN Staff Writer
 With the news of the Supreme Court upholding the 2010 federal health care law on Thursday, July 28th, the decision has sweeping ramifications for consumers, state officials, employers and health care providers.
Some of the key features do not kick in until 2014, leaving consumers and employers with many questions.
- how to buy insurance if you don't already have it,
- what happens if you don't buy insurance,
- keeping your current coverage offered through your employer,
- affording health insurance,
- obtaining coverage with heath problems, and
- if you own a business, information on if you have to buy health insurance for your employees
If you have additional questions that this article does not address, please don't hesitate to contact us.
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Announcing the 2012 Shirazi Benefits Webinar Series
Shirazi Benefits is excited to announce our 2012 Webinar Series. These series are provided at no cost to you and are even Insurance CE & SHRM credit eligible!
Our first series examines the impact of key economic, regulatory and marketplace challenges facing employers. The study covers two main areas of inquiry; broad macro trends and employee benefits. This study also discusses the implications of these trends for employers. Insurance CE & SHRM credit eligible. Presented by Hilary McCart with Unum
The following webinars will be available for registration once the dates draw closer. In the meantime, please mark your calendars.
- Thursday, August 9th, 2012 - 10am-11am MST - Healthcare Reform Update
- Thursday, September 13th, 2012 - 10am-12pm MST - Legal Considerations When Developing An Employee-Sponsored Wellness Plan
- Thursday, October 11th, 2012 - 10am-11am MST - ERISA 101
- Thursday, November 8th, 2012 - 10am-11am MST - ERISA 102
- Thursday, December 6th, 2012 - 10am-11am MST - ERISA 103
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Carriers Offering Assistance to Those Impacted by Colorado Wildfires
 Early Prescription Refill Eligibility in Fire Zones
In order to ensure members have access to the prescriptions they may need during this difficult time, several carriers have put in place an override process so Colorado fire victims can get early prescription refills. Members in the following zip codes will be able to go to the pharmacy to obtain their prescriptions, even if they are not yet available for refill.
Aetna
Aetna Behavioral Health is offering its Employee Assistance Program resources to any Aetna customers and members who have been affected by the fires in Colorado, regardless of whether or not they are Aetna EAP customers or members. Affected individuals can contact Aetna EAP at 888.AETNA.EAP (888.238.6232) for telephonic consultation and general information.
Anthem
Zip Codes eligible: 80819, 80809, 80904, 80512, 80535, 80536, 80538, 80541, 80545. This override process will be in place for the above zip codes until July 15, 2012.
EAP Assistance: Anthem has activated the EAP Disaster Response program, where members will have access to 24-7 telephonic crisis counseling by calling 877.208.8240.
Cigna
Members in El Paso, Larimer, Montezuma, Lake, Archuleta, Boulder, Teller, Elbert, Washington and La Plata counties are eligible for early prescription refills from 06/26/2012 - 07/26/2012.
Rocky Mountain Health Plans
United Healthcare
A toll-free number (866.342.6892) is available for UHC members and non-members alike 24 hours a day, seven days a week, for as long as necessary. Specially trained OptumHealth mental health specialists are specialists that help people manage their stress and anxiety so they can continue to address their everyday needs. OptumHealth has also put together Wildfires: Coping After a Disaster, a resource that focuses on your emotional well-being after a disaster.
Prescription Refills: If members are evacuated and don't have their medication, or wish to prepare for an evacuation, they can ask their pharmacist to obtain a prescription override (assuming there are still refills left or it's not a narcotic drug).
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FSA Use-It or Lose-it Fix Bill
Members of the United States House of Representatives voted Tuesday, June 7th to pass H.R. 436, the Health Care Cost Reduction Act of 2012 bill. H.R. 436 is a health package that includes the elimination of the requirement that Flexible Spending Account (FSA) participants forfeit any unused FSA balances at the end of the year. The other parts of the bill are as follows;
- The bill will restore FSA and HSA holders' ability to use account contributions to pay for over-the -counter drugs without getting a prescription from the doctor.
- The bill will repeal a 2.3% excise tax on medical devices that is set to be imposed by the Patient Protection and Affordable Care Act of 2010 (PPACA).
- Taxpayers will be required to return 100% of any extra PPACA health insurance credit they get.
The White House says senior advisors will tell President Obama to veto the bill if it reaches his desk, but 37 democrats crossed party lines to vote for the bill in the House. Members of the Senate have started the process of considering H.R. 436.
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Anthem Files Report on Medical Loss Ratio Rebates for Colorado
(Individual market rebates only)
The Affordable Care Act (health care reform law) requires health plans to meet a minimum medical
loss ratio, which varies according to market. Health insurance issuers must meet a minimum medical
loss ratio of 85% in the fully insured large group market and 80% in the fully insured small group and
individual markets. (States that received waivers to have a lower threshold for the individual market
are required to meet that percentage, not the 80% in the Affordable Care Act.)
The health care reform law also requires health plans to file a medical loss ratio report each year with
the Department of Health and Human Services. On June 1, 2012, Anthem filed the required medical loss
ratio report for the 2011 calendar year.
Anthem met the required loss ratio in the small and large group markets, but not in the individual market
for their Rocky Mountain Hospital and Health Services, Inc. (doing business in Colorado as Anthem Blue
Cross and Blue Shield) products.
This means members in all small and large fully insured groups will get postcards with this information notifying them that Anthem met the minimum medical loss ratio and no rebate will be issued. In the individual market, Anthem will send the required notification along with the rebate check as required by law to individuals having PPO policies in 2011.
All rebate checks and notices will be sent before August 1, 2012.
There are no restrictions on how individuals can use their rebate checks.
You can also view the questions and answers document if you have any other inquiries.
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Anthem Tobacco Rating
Effective September 1st, 2012 for new business and upon renewal after September 1st, 2012 or after for current business, Anthem will issue a 0-15% rate factor on member's age banded rate if the member is a smoker. If a spouse is a smoker, the spouse will also be issued the rate load.
Smoker status will be collected 90-120 days prior to the group's renewal where the member will self-report their status to Anthem as either a smoker or a non-smoker. You, as the employer, can choose to pass on all costs directly to the employee if you wish to do so as the tobacco load will show up as a separate line item on the bill next to the employee's rate.
Anthem will remove the rate load if the employee/spouse quit smoking or enroll in a tobacco cessation program.
Please get in touch with your Account Manager if you have additional details.
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