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In This Issue

 

 

 

United Concordia Dental Health Study 

 

Aetna Member Outreach For In-Person Health Assessments 

 

UnitedHealthcare to Cover Tobacco Cessation Drugs at No Cost Share, Jan 1st 

 

Enforcement Delayed for Health Plan Identifier  

 

Reinsurance Fee and Health Plan Identifier (HPID) Action Required for Self-Funded Employers

 

 

Individual 2015 Open Enrollment and SHOP Exchange

 

 

Question of the Week

 With Exhange Coverage Available, Do Employers Still Need To Offer COBRA?

 

Answer

 

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INSURANCE SPOTLIGHT

November 6, 2014

Carrier News

 

United Concordia Dental Health Study

UCDI's oral health study was published in the American Journal of Preventive Medicine. The study sdental toolshows how reduced hospitalizations and medical costs are possible when people with certain chronic conditions or women who are pregnant complete their treatment for gum disease. Oral wellness can lead to overall wellness. Study results

  

Aetna Member Outreach For In-Person Health Assessments

Thaetna logoe Affordable Care Act is changing the way consumers engage in their health care. More and more consumers are entering the health care system. Many of these individuals have not had access to coverage for some time. They may not be aware of their current health needs or how their plan can help them manage their care.  

 

Recognizing this need, Aetna continues to explore ways to engage its Individual and Small Group members. Beginning this month, Aetna will be reaching out to these members with an invitation to participate in an in-person health assessment. In most cases, the health assessment will be conducted in the member's home. In certain locations, members may also have the option to complete the in-person assessment at a local clinic, if there is a convenient location near them.

 

The information gathered through the health assessment will help Aetna to work with the member's primary care physician (PCP), if they have one, to coordinate their care and also identify if they are eligible for any of the care or disease management programs. Outreach will began this October and expand as they move through the rest of the 2014 and into 2015.  Read more   

  

UnitedHealthcare to Cover Tobacco Cessation Drugs at No Cost-Share Jan. 1

The Departments of Labor, Health and Human Services and the Treasury issued a series of FAQs on May 2nd related to preventive care, and specifically tobacco cessation interventions, under the Affordable Care Act.  

  

In response to the Department's FAQ, UnitedHealthcare is modifying its approach to tobacco cessation drugs for  customers that follow their preventive care services benefit and offer OptumRx carve-in pharmacy benefits. These updates will be effective Jan. 1, 2015, for their fully insured plans. Read more 

Federal & State News

This Will Make Up For No Updates Two Weeks Ago! 

  

Enforcement Delayed for Health Plan Identifier Regulations

HHS Logo On October 31, 2014, the Department of Health and Human Services (HHS) announced that, until further notice, it will delay enforcement of regulations related to obtaining the Health Plan Identifier (HPID) and using the HPID in Health Insurance Portability & Accountability Act (HIPAA) transactions that were adopted in the HPID final rule.

  

This enforcement delay applies to all HIPAA covered entities, including health care providers, fully insured and self-funded health plans, and health care clearinghouses. The National Committee on Vital and Health Statistics (NCVHS), an advisory body to HHS, issued a written recommendation asking HHS to review the HPID requirement. Read more 

  

DeadlineCountdown to Compliance: Reinsurance Fee Action Required for Self-Funded Employers

Key compliance dates for a Patient Protection and Affordable  Care Act (PPACA) provision is quickly approaching.

  

Employers sponsoring self-funded group health plans must Reminder report the average number of covered lives in 2014 to HHS by November 17, 2014, which is the next applicable day after the November 15th regulatory deadline. This means that covered lives data must be uploaded into Pay.gov, and The Form must be submitted by November 17, 2014. Again, you're encouraged to do this no later than November 15th to avoid technical difficulties.    

 

Section 125 Plans

The Internal Revenue Service announced annual inflation adjustments for 2015.  Revenue provides that for taxable years beginning in 2015, the maximum amount that an employee may contribute to a health flexible spending arrangement (FSA) is $2,550, an increase of $50.  Notice

  

Individual 2015 Open Enrollment and SHOP Exchange

Exchange Individual Exchange enrollment starts Saturday, Nov. 15, 2014, and ends Feb. 15, 2015.

 

WAHealthplanfinder.org will also have small group plans available for 2015 coverage through the Small Business Health Options Program (SHOP) beginning November 15, 2014. SHOP enrollment for small groups was delayed last year. Please contact Doug, Becky, or Marjorie if you have questions regarding either individual open enrollment or the SHOP Exchange.

 

Health & Wellness

What Is Influenza?

The flu is a contagious respiratory illness caused by influenza Flu shot viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccine each year.  

 

For key facts about the flu including symptoms, how it spreads, and periods of contagiousness look here

 
If you have any questions about the articles contained in this newsletter, please give us a call or e-mail us: