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INSURANCE MATTERS
A Newsletter for Members of the CCAP Insurance Programs
Owned by Members, Governed by Members, Service to Members
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| March 2009 |
Volume 13, Issue 3 | |
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| Specialty Lines |
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Hello ,
One of the things we try to emphasize about CCAP's insurance programs is that they differ from traditional commercial insurance in some significant ways. The most important one of these is ownership and management by the participating counties. Nowhere is this more evident than in the participation on, and management by, the various insurance boards and committees. In the last issue of Insurance Matters we listed the people who serve on each program's governing board.
Here is the overview of this participation. We have nine boards or committees with 95 county officials and staff as members. Here is the composition of the boards by title of the members:
Number % Of Total
Commissioners or
Council Members 35 37%
Chief Clerks or
County Administrators 14 15%
Human Services Staff 12 13%
HR/Personnel Directors 10 11%
Nursing Home
Administrators/Staff 5 5%
Row Officers 5 5%
Wardens 5 5%
Finance Directors 3 3%
Risk Managers 1 1%
Other 5 5%
I am pleased to report these individuals come from 52 different counties! Through a combination of appointments by the CCAP President and elections from the program members, we are rewarded with representation from all parts of the state and all sizes of counties. This ensures the members of the insurance programs that county concerns and needs are addressed in the operation of each program.
Make sure you call us when you need help with something,
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| Fourth Annual NACO/ Nationwide Scholarship: High School Senior Can Win $2,000 For College |
Article provided by the National Association of Counties (NACo)
This spring, four high school seniors will earn $2,000 for college from the NACo/Nationwide Scholarship. Winning applicants will have written a short essay describing the most important actions in 2009 that a public sector employee can take to help them get ready for retirement or that the new President and Congress can take in 2009 concerning America's retirement savings.
This is the fourth year in a row that Nationwide and the National Association of Counties have teamed up to encourage high-school seniors to think about retirement.
Why spur students who haven't even started full-time work to think about retirement? Three reasons - by applying for the scholarship the students:
1. Must consider the financial impact of their decisions about college and their career and realize it is never too soon to start thinking about saving for retirement
2. Begin to recognize the value perspective in turbulent financial times when often difficult decisions are required
3. Identify specific actions that help prepare for a financially successful future
To be eligible, applicants must be graduating high school seniors who are legal U.S. residents, their parent or grandparent must be enrolled in and contributing to the NACo 457 Deferred Compensation Plan, and the student must enroll in a full-time undergraduate course of study no later than the fall term of the 2009-2010 school year at an accredited two- or four-year college. Application and entry must be submitted on line no later than March 15, 2009.
The NACo/Nationwide Scholarship is just one of the services arising out of nearly 30-year partnership between Nationwide and NACo. As provider of the NACo deferred compensation program, Nationwide regularly reports to the NACo Deferred Compensation Advisory Committee on industry trends, updates statistics on the program and provides ongoing education on retirement issues. NACo receives from Nationwide Retirement Solutions payment for NACo's endorsement and license of its name and logo for use by Nationwide in connection with the NACo Deferred Compensation Plan and related products and services. These funds are used by NACo to enhance programs and services for the benefit of its members.
For More Information About The Scholarship
All of the information about eligibility, judging criteria and notification process are on the NACo and Nationwide Web sites. For more information, go to www.naco.org/retirementscholarship or www.nrsforu.com and click the Scholarship link.
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| PComp Annual Membership Dinner Being Held At CCAP Spring Conference |
The annual meeting of the PComp members will be held on Sunday, March 29 at 6 pm at the Harrisburg Hilton.
The meeting is open to representatives of all members of the workers' compensation insurance pool, and their local insurance producers. There is no cost to attend, and attendees may bring their spouse or a guest. Pre-registration is required, so we may have the proper seating and order the correct number of meals. After dinner a brief update on PComp will be presented, as well as the 2009 PComp Awards.
Invitations were sent via email to all PComp representatives and local producers, and in hard copy to each chief clerk or agency executive director. You may also register to attend by emailing Tona Faust at CCAP: tfaust@pacounties.org or calling Tona at 800-895-9039, extension 3357.
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| Getting Through The Economic Sausage Grinder* |
By Linda Rosito, Insurance Training Director
What is Getting Through The Economic Sausage Grinder?
All of us are experiencing what may be the most challenging times of our lives both at work and at home. With so many of us facing uncertain personal and economic stability, we must understand what our options are and plan carefully to get through this.
To address these unprecedented challenges, this training will focus on two of the most pressing concerns we face: The first half of this program will look at our personal financial situations, offering ideas and solutions to carry us through these trying times. The afternoon session will look at the impact of personal, financial and work stress on how well we cope emotionally and function at work. Please join us for what may be a very insightful day of learning, sharing and growing.
This workshop will be offered in 5 locations; April 15, Hilton Garden Inn, Erie; April 16 Penn Stater, State College; April 23, Hilton, Scranton; April 29, CCAP North Office Building, Harrisburg and May 20, Best Western Country Cupboard, Lewisburg and are free to members of CCAP UC Trust.
For additional information on these and any workshops this spring, please go to Glimpse Online. The CCAP website has been updated and has a different look, please follow the prompts to search spring workshops.
If you have not already received a copy of the Glimpse and would like one, please contact us. As always if you have any questions, please feel free to contact Linda Rosito or Jenn Carey. We look forward to seeing you this spring!
* Denotes Academy for Excellence in County Government credit opportunity.
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| Changes Happening In Unemployment Compensation Benefits |
With the passage of the American Recovery and Reinvestment Act (ARRA) into law on February 17, 2009 a number of unemployment compensation (UC) provisions were enacted which not only increase benefits, but increase the number of benefit-eligible workers.
Important UC provisions contained in the newly enacted bill are as follows:
Emergency Unemployment Compensation (EUC) Extension - provides for continuation of the EUC program initially implemented in July 2008 and then extended in November 2008. This latest extension continues EUC through December 31, 2009. The EUC program continues to be 100% federally funded, meaning there is no cost to counties whether you are a reimburser (as are all member of the CCAP UC Trust) or tax contributor.
UC Benefits Increase - provides for an additional $25 to be added to a person's weekly unemployment benefit amount through 2009. Employers will bear no costs for this provision, as these additional benefits will be 100% funded from federal general revenue.
UC Modernization - makes one-time funding available to states as incentive to implement reforms to expand benefit eligibility to persons not typically covered. States will get a portion of $7 billion, if they have enacted or will enact an "alternate base period" - an alternative to the standard earnings period used to establish a UC claim - as well as two of four other benefit expansions:
1) part-time worker eligibility;
2) compelling family reason quit eligibility;
3) benefits for dislocated workers in approved training; and
4) dependent allowances.
The incentive funding is meant to cover states' administrative costs associated with the expansions. Each state will need to determine whether or not employers will be charged for benefits paid under the new provisions.
Capitolwire, a legislative reporting service based in Harrisburg, reports the Pennsylvania Legislature will need to change unemployment benefit eligibility to receive all stimulus funds. Pennsylvania already covers part-time workers, which is one of the four groups. The other three - dependents, people enrolled in job training and people who lose their jobs due to family problems, such as domestic violence - would require more coverage than current state law allows.
In testimony given to the House Appropriations Committee February 18, the Department of Labor and Industry reported administering the new programs could create additional costs for the commonwealth. Although the federal government will pay for the increase in benefits, the state will have to foot some of the administrative costs. The stimulus package will provide money for some of the administrative costs, but it is not yet clear how much.
The U.S. Department of Labor is currently developing guidance for the states, relative to the economic recovery package. Business groups have voiced concerns that ARRA provisions significantly alter some fundamental elements of the unemployment insurance program, but it will ultimately be up to individual state legislatures and UC agencies to decide how the changes will be carried out and to what extent employers may see increased unemployment costs.
NOTE: Information for this article came from the February 2009 Unemployment Bulletin from TALX, the claims administrator for the CCAP UC Trust, and from Capitolwire.
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| Important Liability Claims Changes! Medicare And Medicaid Set- Asides And Reporting: Are You Prepared? |
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By Dave Harman, Claims Supervisor
In 2008, the Centers for Medicare and Medicare Services (CMS) released information regarding the reporting requirements pursuant to Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) for both Group Health Plans (GHP) and liability insurance, which can be accessed online at https://www.cms.hhs.gov/MandatoryInsRep/. Following up on Congress's initiative to expand the secondary payor recoveries under the Medicare program, Pennsylvania has become one of the first states in the country to revise its third-party liability (TPL) program under Medicaid to adopt many of the more aggressive Medicare MSP provisions. The purpose of both these initiatives is to enable both programs to gain a "seat at the table" in court cases as well as pre-litigation settlements where the injured party is a recipient of either program.
While both initiatives are attempting to reach the same outcome, there are differences between the two, especially in reporting requirements. Below is what we know at this time in regards to both programs.
Medicare:
Beginning July 1, 2009, all liability claims that involve a Medicare Eligible Recipient needs to be submitted to Medicare. The Submissions must be in an electronic format and failure to properly comply with Medicare's reporting requirements will result in a $1,000 per day penalty per claim.
These reports to Medicare must include the identity of a Medicare beneficiary, whose illness, injury, incident, or accident was at issue as well as such other information specified by the Secretary to enable an appropriate determination concerning coordination of benefits, including any applicable recovery claim. Responsible reporting entities (RREs) such as PCoRP will have to register with the Medicare Coordination of Benefits Contractor (COBC) for mandatory reporting. As mentioned above, the CMS Website makes it clear that although an RRE may use an agent for reporting purposes, the RRE itself must complete the registration process directly.
Through the registration process, the COBC will obtain the information needed to:
- certify the registrant is a valid RRE for Section 111
- assign a Section 111 Reporter ID to each RRE
- develop a Section 111 reporting profile for each RRE, including estimates of the volume and type of data to be exchanged for planning purposes
- assign a production live date and file submission timeframe to each RRE
- establish the necessary file transfer mechanisms; and
- assign a COBC Electronic Data Interchange Representative (EDI Rep) to each RRE to assist with ongoing communication.
Entities, responsible for complying with Section 111 Reporting Requirements, such as CCAP's PCoRP program, will register on the COB Secure Website (COBSW). An authorized representative from the RRE will complete and submit the registration for the RRE using a new internet-based application on the COBSW. When a registration application is submitted, the information provided will be validated by the COBC. Once this is completed, the RRE will be instructed to assign an account manager, who will return to the COBSW to complete account setup and obtain Login IDs for individual users associated with that account. The account manager will be the administrative contact for the RRE and will control the overall account profile. All users associated with the RRE's account will be able to submit test and production files, maintain account information and monitor the status of file processing using COBSW.
Further details regarding when and how reporting must be done remain subject to specifications by the Secretary of the Department of Health and Human Services. Required reporting information shall be submitted within a time specified by the Secretary of the DHHS after the claim is resolved through a settlement, judgment, award or other payment (regardless of whether or not there is a determination or admission of liability)
Here is the rest of the projected timeline for implementation:
- 7/1/09 - 9/30/09 Testing period for all liability/no-fault/workers' compensation RREs
- 10/1/09 - 12/31/09 All liability/no-fault/workers' compensation RREs submit their first Section III production files based upon a pre-determined schedule with the COBC
- 1/1/10 All liability/no-fault/workers' compensation RREs will be submitting Section III production files by this date.
At this juncture, counties may want to begin considering whom they would like to assign as account manager. It is recommended that a person with excellent computer skills might be a good candidate. It is also recommended that you make sure that your insurance company or TPA is equally equipped to handle these new requirements.
Medicaid:
On July 4th, 2008, Governor Rendell signed Act 2008-44 (Act 44) into law. As stated above, the Act made significant changes to the TPL procedures of Medicaid. The complete details of Pennsylvania's TPL program can be found in a Statement of Policy that was issued by the Department of Public Welfare (DPW) and published in the November 1, 2008, edition of the Pennsylvania Bulletin. This Statement of Policy not only implements the changes to the TPL procedures, it also implements changes to certain elements of federal law. Most notably, where DPW is required to recover costs of Medicaid expenditures from liable third parties, including tort features.
As with Medicare, it is incumbent that if anyone who is eligible to receive Medicaid benefits is injured, that the TPL division of DPW be identified. Failure to report an eligible claim to DPW may result in a fine of $5,000. Further, DPW may impose a civil penalty of up to $1,000 per violation upon any person or organization who willfully fails to disclose a material fact regarding third party liabilities for a beneficiary's injuries.
These new reporting requirements and fines went into effect November 1, 2008!!!
While the Medicaid changes have already been implemented, there is no formal process to report these cases to DPW. It is anticipated that DPW will simply follow along with the reporting format that will be devised eventually by CMS.
What Do Counties Need To Change?
The days of offering a citizen who has been injured on your property money for their "out-of-pocket" medical expenses are over. It is imperative that the county make sure that an injured party is not a Medicare or Medicaid recipient before making such an offer. If an injured party is identified as being a recipient of one of these programs it is imperative that you contact your insurance carrier and notify them of this development and let them handle the matter. By making any form of payment, no matter how good the intentions are, you could be exposing the county to costs and fines levied by DPW or CMS for not reporting a claim.
CCAP's Insurance Programs (PComp, PCorp, COBLAT & PELICAN) have already started to address the necessary issues surrounding these matters including setting up reporting guidelines and contracting with experts to handle the set-aside issues for them. If you are not a member of one of these programs you need to contact your TPA or insurance company to make sure that they have also addressed these issues and has the county protected. If you are self insured you need to address how you are going to comply with the new regulations.
There are many more facets of these new regulations that could result in thousands of dollars having to be spent in fines and costs. But this can all be avoided if you are proactive with these requirements and make sure that the county's insurer is prepared for these changes.
*Information for this article has been taken from legal reviews of the new regulations by John Yaninek, PCoRP Corporate Counsel and Paula Sanders, PELICAN Corporate Counsel.
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| New COBRA Provisions |
By Tom Dean, Vice President, Insurance Solutions Group and consultant for the CCAP BEST Flex Program
On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA). While most of the provisions of this act deal with infrastructure spending, tax reductions and other measures to aid economic recovery, the act also provides additional assistance to workers who have lost their jobs due to the economic slowdown.
Of particular note to insurance professionals are provisions within the act that provide government subsidies for COBRA premiums.
The subsidies available under the ARRA are available to former employees (and other qualified beneficiaries associated with the former employee) who lose their jobs on an involuntary basis between September 1, 2008 and December 31, 2009.
The amount of the subsidy available to eligible Qualified Beneficiaries is equivalent to 65% of the COBRA premium. The subsidy, although provided by the government, is credited to the former employee prospectively by the employer. Employers may therefore only collect 35% of the eligible COBRA premium from the qualified beneficiaries and then take a credit of the eligible premium amounts against Federal payroll tax filings.
Subsidies under this program are limited to a 9 month period. This, however, does not otherwise limit the normal maximum period of COBRA continuation available to any particular beneficiary. Furthermore, although a new COBRA election period is made available under the act, the maximum period of continuation is not extended.
For example, an employee who was laid off in September of 2008 would be eligible for the subsidy starting in March of 2009 (the first month following the date the law went into effect). They may then choose to elect COBRA and receive the remainder of the 18 months of continuation that would have begun had they elected COBRA during the initial 60 day election period that began in September of 2008. Premiums for the first 9 months of continuation beginning in March of 2009 would be subsidized but premiums for the remaining few months of coverage would not be subsidized. Continuation coverage under this example will still be exhausted 18 months after the original loss of coverage, either March or April of 2010, depending upon the original notification dates and the contract provisions.
The Department of Labor (DOL) is required to provide a model notice for employers to utilize to make individuals eligible for assistance aware of the new election period and reduced premiums available under the act. It will most likely be several weeks before the notice is available.
We will provide additional information in the coming weeks as we continue to review the legislation as well as the anticipated guidance and notices from the DOL.
For more information on the new COBRA provisions email Tom Dean, Vice President, Insurance Solutions Group, or call 724-933-7320.
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| Save Money, Eat Right |
By Mary R. Ehret, M.S., R.D., L.D.N., Penn State Extension Educator
During the month of March, health professions celebrate National Nutrition Month. The American Dietetic Association's National Nutrition Month® theme for March 2009 is "Eat Right" and Penn State Cooperative Extension can help you do it!
Penn State Cooperative Extension has offices in every county and can provide researched-based nutrition information about eating right. Each year, more than eight million Pennsylvanians participate in Extension programs. Taking the university to the people, Extension offers many nutrition related programs right in your own county. To find your local office and what programs they are currently offering, go to www.extension.psu.edu and click on your county.
Dr. Lynne Brown, professor and author of Roadmap to Wellness, a self study program designed to help consumers eat right, states that "You can begin by choosing foods with less saturated and trans fats and with more fiber." Choose fiber-rich fruits, vegetables, and whole grains often to make a healthier diet. Soluble fiber is important for reducing risks of heart disease and diabetes. It is found in oats, beans, peas, seeds, and fruits. Consumers can use MyPyramid.gov and the Nutrition Facts panel on food labels to help identify fiber rich foods.
Penn State Cooperative Extension Nutrition Links program focuses on helping families with limited resources eat better for less. Participants learn how to manage limited food dollars and resources, and how to plan and prepare healthy foods. To find our more, call 1-888-778-3535 or visit http://nutrilinks.cas.psu.edu.
Meanwhile if managing your food dollars wisely is a priority in your home, here are three actions you can begin doing today if you are not already. First, plan your meals using store specials or food items that you have on hand. Second, make a grocery list and stick to it. Third, use unit pricing to find the better buy. If you don't know about unit pricing, just visit extension's web site to learn more.
Begin March by eating at home more often. Not only will you save money but enjoying a family meal together gives families the opportunity to reconnect. Here is a great recipe to begin March by eating right!
Italian Wedding Minestrone Soup
Makes 8 servings, 1 cup each
2 teaspoons cooking oil
1 onion, chopped
2 or 3 large garlic cloves, minced
1 14½ ounce cans low sodium chicken broth
1 16 ounce can of stewed tomatoes or diced tomatoes
1 16 ounce can kidney beans, drained and rinsed
1 10 ounce package frozen vegetables
Or 1¼ cups fresh vegetables, peeled and chopped
1 teaspoon dried basil, oregano or Italian seasoning
½ cup uncooked pasta, such as rotini, macaroni, or small shells
1. Wash hands
2. Heat oil in large saucepan. Sauté onion and garlic.
3. ADD broth, tomatoes, beans, frozen or chopped vegetables, and seasoning. Stir to mix.
4. BRING to boil on medium-high heal.
5. STIR in pasta. Reduce heat to medium-low. Simmer about 20 minutes until the pasta is tender.
Serve with corn or whole wheat bread, shredded cheese, milk and a baked apple.
For more information email Mary R. Ehret, Penn State Extension Educator, or call 570-602-0600.
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| Preventing Strains And Sprains |
By Gary Nicholson, CHSP, Senior Loss Control Specialist
 Strains and sprains are injuries resulting from stretched or torn muscles, tendons and ligaments. Lifting, pushing, and overreaching are common causes of strains and sprains. Any job that requires you to sit or stand bent in an awkward position for long periods of time can cause excess stress and strain on muscles. Most strains and sprains affect the back, arms, and shoulders. However, there are some very simple things you can do to prevent or minimize body strains and sprains.
Many strains and sprains occur because of poor material handling. Employees will try to lift things that weigh too much or they lift incorrectly. Lift correctly by bending your knees, not your back. Carry loads close to your body. Injuries can occur when employees try to pull or lift a heavy or awkward object without help or lift an object while twisting from the waist. When carrying a load, avoid bending or lifting upward unnecessarily. It is important to keep as much of the load as you can at waist level.
Get help with heavy loads. Don't try to move or lift an object you can't handle. Instead of trying to lift a 75-pound load, break it down into smaller parts. If you can't break it down, get help by using a mechanical device, or lift it with another employee. If using a mechanical device make sure the mechanical device works properly or it could cause you to strain unnecessarily just trying to get it to work. If the wheels on a cart are not aligned, you could strain your arms, shoulders, and back trying to move it.
Remember to change your working positions frequently. Chronic strain due to an unchanging work position can weaken your back, arms, and shoulders. Adjust working heights to prevent slumping or excessive reaching. A vicious cycle develops when chronic strain continues; muscles become less able to withstand strenuous activity and grow more prone to injury of all kinds. Stretch during the day to increase your flexibility. Take body relaxation breaks by letting your shoulders and neck muscles go limp; swivel your head or arms or flex your hands and fingers.
It is important for you to take care of your whole body with exercise, proper posture, a sensible diet and adequate rest. If your muscles or ligaments have weakened over time from lack of exercise or age, you are more apt to get a strain or sprain than if you are physically fit.
For more information email Gary Nicholson, Senior Loss Control Specialist or call 800-895-9039.
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| Quote Of The Month |
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"It's not who we are that holds us back,
it's who we think we're not."
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CCAP Insurance Programs
PO Box 60769, Harrisburg, PA 17106-0769
Phone (800) 895-9039 - FAX (717) 526-1020
Claims Fax (888) 692-2368
Click here to go the Insurance Section of the CCAP Website.
email:jsallade@pacounties.org
Insurance Matters is published monthly by CCAP Insurance Programs for the use of members of CCAP's UC Trust, PCoRP, PComp, PIMCC, COMCARE, COMCARE PRO, BEST Flex, PELICAN and other insurance programs, and insurance producers of these members.
Advice contained in this publication is not legal advice and members are encouraged to seek the opinion of their solicitor.
The information provided in this publication is not intended to take the place of professional advice. Readers are encouraged to consult with competent legal, financial, or other appropriate professionals. Statements of facts and opinions expressed in this publication, by authors other than Association staff and officers, are the sole responsibility of the authors and do not necessarily represent an opinion or philosophy of the officers, members and staff of the County Commissioners Association of Pennsylvania (CCAP). No endorsement of advertised products or services is implied by CCAP unless those products or services are expressly endorsed, or are owned or managed by the Association programs, or our affiliates. This publication may not be reproduced, modified, distributed, or displayed in part or in whole, by any means, without advance written permission of CCAP. Please direct your requests to John Sallade, Managing Director, CCAP Insurance Programs, jsallade@pacounties.org.
Note: As part of its copyright agreement the CCAP grants the author the right to place the final version of his/her manuscript on the author's homepage, subject to CCAP's standards, or in a public digital repository, provided there is a link to the CCAP website.
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