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! |
AmeriHealth NJ: January 2010 Newsletter
This newsletter includes informative
articles on ARRA, Group and Member Portal Enhancements, IHC HMO Renewals, and
Self-Injectable Drug Coverage.
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Anthem: New Form 5500 Reports to be Available in
April
We are developing an automated system for producing
reports for ERISA 5500 Schedules A and C. The automated process will first
affect groups with ERISA plan years ending December 31, 2009 (i.e., January
renewal groups).
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Capital Blue Cross: Massachusetts
Health Care Reform Act of 2006
On July 1,
2007, the Massachusetts Healthcare Reform Act became law in the Commonwealth of Massachusetts. As a result, all adult
residents of Massachusetts
(age 18 and older) must maintain a minimum level of health coverage, referred
to as minimum creditable coverage (MCC). In addition, they must provide
proof of this coverage (1099-HC form) to the Commonwealth or they could be
subject to financial penalties.
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Capital Blue Cross: New Utilization Management Vendor
Capital
BlueCross has partnered with a new vendor, Landmark Healthcare Services, Inc.
(Landmark Healthcare), for in-area outpatient physical and occupational Therapy
(PT/OT) utilization management services effective January 1, 2010. In
conjunction with these services, Landmark will use claims experience to assign
PT/OT providers to one of three tiers based upon their utilization history
performance relative to their peers within the Capital BlueCross network. This
information is updated monthly and detailed reports are available to PT/OT
providers through the Capital BlueCross PSS website (Capital BlueCross will
have access to this reporting as well).
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CIGNA: Short and Long-Term Disability Taxation and
Compliance Issues
This paper is intended to serve as a
general reference for issues relating to taxation, tax withholding and tax
reporting of insured and self-insured Short and Long Term Disability Benefits. This paper serves as a guide which explains
CIGNA Group Insurance position on these issues.
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Health America: Holy Redeemer Health System Contract Set to
Expire
Effective
March 1, 2010, Holy Redeemer Hospital
and Medical Center will be an out-of-network
provider for HealthAmerica members.
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Health America: Network Update
Albert Einstein
Medical Center
and Moss Rehabilitation Hospital
and HealthAmerica have reached an agreement that provides HealthAmerica members
with continued access to health care services provided by these hospitals. Our
members can continue to receive services from these facilities without
interruption.
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Horizon BCBS of NJ: Q & A about Advantage Formulary and DAW
Programs
Following
the implementation of the Advantage Formulary and Dispense As Written (DAW)
programs, as communicated in December 2009, Horizon Blue Cross Blue Shield of
New Jersey would like to address several questions that are being frequently
asked by the broker community.
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