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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! |
 Save the Date: Healthcare Reform Webinar June 15, 2010
Please join us on Tuesday June 15th from 2:00 to 3:30 for our informative
Healthcare Reform webinar presented by Duane Morris which has been designed
specifically for Model Consulting clients.
This program will provide an overview and discussion of the healthcare
reform provisions of the Patient Protection and Affordable Care Act ("PPACA")
and the Health Care and Education Reconciliation Act of 2010 which impact s
employers as administrators of group health plans. Special focus will be placed on the provisions
of these laws which become effective in the coming months.
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Aetna: Network Update
Retinovitreous
Associates (PA/DE) and Associated Retinal Surgeons (NJ) d/b/a Mid Atlantic
Retina has notified Aetna of its termination
from the network effective July 16, 2010. While Aetna
is committed to reaching a mutually acceptable agreement so that Mid Atlantic
Retina might continue in our network, we have not yet been able to come to an
agreement to date.
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AmeriHealth NJ: Newsletter
This edition of AmeriHealth's newsletter
includes articles on Dependents to Age 26, SEH Benefit Materials, Autism
Coverage Mandate, Select Drug Formulary Update, and Special Olympics.
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AmeriHealth NJ: Training Available for the New
Amerihealthexpress.com
Want
to learn more about how amerihealthexpress.com
can simplify HR tasks? AmeriHealth is offering convenient ways for you and your
customers to learn more about our enhanced site.
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Capital
Blue Cross: Small Business Tax
Calculator
The Patient
Protection and Affordable Care Act (PPACA) includes a provision for a small
employer tax credit. The credit is designed to encourage small employers to
offer health insurance coverage for the first time or to maintain existing
coverage for their employees. Many small businesses and tax-exempt
organizations that provide health insurance coverage to their employees may now
qualify for this federal tax credit.
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Geisinger: Participating with Hospital of the University of Pennsylvania
Geisinger is pleased to announce that Hospital of the University of Pennsylvania and its affiliates are now
participating with Geisinger Health Plan.
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Health Care Reform Confusion: The Age 26 Coverage
Mandate vs. the Age 26 Tax Exclusion
By Gail Olsen, JD Reinhart Law golsen@reinhartlaw.com
Two of the provisions in the health care reform act are causing substantial confusion. They sound similar, but are really two different things: the first is a coverage mandate; the second is a tax exclusion.
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Highmark Blue Shield: May Newsletter
This edition of Highmark's Newsletter
includes articles on Wellness Topics, Wellness on the Web, Wellness Discount
Program, Membership and Billing Inquiries, Health Care Reform, and Online Drug
Formulary Changes.
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Horizon BCBSNJ: Coverage for Dependents Q & A
As
previously communicated, Horizon Blue Cross Blue Shield of New Jersey will
allow covered individuals under age 26 to remain on their parents' health
insurance policies, effective May 1, 2010 for fully insured plans to help
families avoid a gap in coverage. This is before the federal effective date of
plan years beginning on or after September 23, 2010. Self-insured groups are
also able to opt-in to this arrangement to prevent disenrollment of certain members
who would otherwise be eligible for coverage on or after September 23, 2010.
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Horizon BCBSNJ: Legislative Bulletin for Groups with 51+
Employees
On September 8, 2010, N.J.A.C. 11:22-5.1, et seq.
will become effective in New Jersey, This new regulation substantially adds to
the existing requirements for network-based plans, and in fact is no longer
limited to network-based plans. It establishes maximum network copayments,
prohibits the application of both network coinsurance and a network copayment
to the same service, constrains the application of out-of-pocket limits,
provides limitations on benefit maxima and revises the cost-sharing requirements
for dental plans.
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Independence Blue Cross: Prescription Drug Coverage Updates
We are making changes to the Select
Drug Program® formulary and updates to the way we manage Suboxone® and Subutex® (buprenorphine), which are narcotic
medications used to treat drug dependencies and addictions.
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UnitedHealthcare/Oxford: Mental Health Parity Benefit Changes
Regulations were recently implemented
under the federal Mental Health Parity and Addiction Equity Act of 2008 (the
"Act") that may affect your small business clients. We want to work with you
and your clients to meet the compliance goals.
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