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Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Your feedback is
extremely important to us. Please contact Tracy Duffield at 215.947.7167 or tduffield@modelconsultinginc.com to share your ideas, comments
and/or suggestions. We look forward to hearing from you!
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Aetna: New NY Law Extends Health Coverage to
Dependents To Age 30
We want you to be aware of a new New York State
law that extends coverage for certain dependents up to age 30. New York
AB9038/SB6030 extends the availability of health insurance coverage to young
adults until age 30. Under this law, effective for new groups or those renewing
on or after September 1, 2009, extended dependent coverage is available via
employer selection or through dependent election.
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AmeriHealth NJ: ARRA Premium
Subsidy Soon Expiring for First Recipients
The
first recipients to receive the American Recovery and Reinvestment Act (ARRA)
premium subsidy under New Jersey Continuation Coverage (NJCC) will soon have
the subsidy expire. As you know, the premium subsidy can last up to nine
months. However, because NJCC entitles health insurance coverage for up to 18
months, the member's health insurance coverage may continue even though their
ARRA premium subsidy has ended.
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Capital
BlueCross: Creditable Coverage
Notification for Medicare Part D
Employer
groups that offer prescription drug coverage to Medicare eligible members are
expected to meet certain requirements of the Centers for Medicare and Medicaid
Services (CMS) regarding the creditable status of the drug coverage offered.
One such requirement is for groups to submit a Disclosure Notice to CMS by a
specified date to disclose whether the prescription drug coverage they offer is
"creditable". A second requirement is to notify all Medicare eligible members
of the creditable status of their plan design.
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Highmark: October Newsletter Released
This month's newsletter includes information on the
Great American Smokeout, Michelle's Law, 2010 Prevention Schedule, Discounted
Wellness Products, Provider Directory Enhancements, and H1N1 Vaccine
information.
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Independence Blue Cross:
Prevacid Available Over-The-Counter
Effective November 12, 2009, Prevacid 15mg, which is
primarily used to treat acid reflux disease, will be available over-the-counter
as Prevacid 24HR. Drugs that have an over-the-counter equivalent are excluded
from all Independence Blue Cross prescription drug programs. Prevacid 24HR is
available at the retail cost of the medication. IBC members that are currently
taking Prevacid 15mg will be notified that this medication is now available
over-the-counter and will not be covered under their prescription drug plan.
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Independence Blue Cross: Updated Information on Overage Dependent
Coverage
Last month IBC released information concerning
their dependent to age 30 policy. In that release there was mention of an
application the dependent would have to complete and send to IBC, in order to
elect the coverage. Attached is the application in question, just
recently released by IBC.
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Oxford: Change to
Out-of-Network Reimbursement Methodology
We are committed to providing your clients with access to quality
and affordable health care. Out-of-network medical expenses are increasing at a
rate above overall medical trends. These trends make up an increasing portion
of overall health care expenditures, which make it difficult for your clients
to find a balance between health care costs and delivering high-quality
benefits. For this reason, effective January 1, 2010, we will be making
a change to the way we reimburse out-of-network services for certain Oxford
products with Liberty Network access and will also will make this change
available as an option for certain New York groups enrolled in the Oxford
Freedom and Oxford USASM Networks.
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