This is a reminder of the federal CHIPRA requirements.  The US Department of Labor requires employers with group health plans to provide CHIRPA notices to all employees.  Please see the attached fact sheet & the below for more information.  Employers are required to provide the notice as of their plan effective date (or renewal date). 

 It’s important to note – The DOL now has the authority to charge monetary penalties to employers who do not comply with the notice requirements! 

Here is a more detailed description of the CHIPRA requirements including links to the fact sheet and model notice: 

 The U.S. Department of Labor (DOL) has published a model notice to help employers comply with notifications required by the Children's Health Insurance Program Reauthorization Act (CHIPRA). Congress enacted CHIPRA last year to extend and expand the Children's Health Insurance Program.

CHIPRA imposes a notice requirement on employers that maintain a group health plan with participants or beneficiaries (e.g., employees, dependents, COBRA-qualified beneficiaries, etc.) residing in one or more states that provide a premium assistance subsidy. The notice must be provided to all employees residing in each premium assistance subsidy state, including employees not enrolled in the plan. The purpose of the notice is to provide employees with information concerning the potential opportunities for premium assistance for themselves and their families in the state where they reside.

The notice may be provided with enrollment packets, open season materials or the summary plan description, but must appear "separately and in a manner which ensures that an employee who may be eligible for premium assistance could reasonably be expected to appreciate its significance", according to the DOL. Employers that fail to issue these notices are subject to penalties of up to $100 per day per employee.

Here is the model notice: http://www.dol.gov/ebsa/chipmodelnotice.doc.

Here is the fact sheet: http://www.dol.gov/ebsa/pdf/fschip.pdf.

Please contact us with any questions or concerns!

Parents: If you need individual coverage for your children, open enrollment is NOW

Open enrollment for individual health plans started Sept. 15 and runs through Oct. 31. (Individual health plans are those bought by individuals, as opposed to health plans offered by employers or groups.)

We can't say this enough: If you need health insurance for your child, make sure you enroll early. If you miss this open enrollment period, you'll have to wait until March 15, 2012, unless you meet certain qualifications. And if you wait until even the beginning of October, your coverage may not kick in until Nov. 1.

Federal health reform prevents health insurers from denying coverage to children because of a pre-existing health condition. However, just like employer-sponsored health plans, insurers can create open enrollment periods. During these open-enrollment times, children under age 19 do not have to complete a health questionnaire and cannot be denied health insurance.

We should note that there are some exceptions. You can apply for coverage for your child anytime in these examples:

•  After the birth or adoption of a child
• Is no longer eligible for a state program such as Medicaid
• Loses coverage due to a divorce
• Loses employer-sponsored coverage (including COBRA coverage)
• Moves and their plan is not available where they live

 Source: http://wainsurance.blogspot.com/2011/09/parents-if-you-need-individual-coverage.html.

On August 1, 2011, the Department of Health and Human Services released an amendment to the Interim Final Regulations for preventive care under the Patient Protection and Affordable Care Act (PPACA). The amendment applies to non-grandfathered individual insurance policies as well as non-grandfathered insured and self-insured group health plans.

The amendment provides additional guidelines for women’s preventive services. Health plans will need to cover women’s preventive services, including birth control, without copayments or deductibles. The guidelines reflect the recommendations made last month by the independent Institute of Medicine.

For plan years beginning on or after August 1, 2012, non-grandfathered plans will be required to cover the following additional preventive care services for women with no cost sharing:

• Annual well-woman visits
• Screening for gestational diabetes
• HPV DNA testing for women 30 years and older
• Sexually-transmitted infection counseling
• HIV screening and counseling
• FDA-approved contraception methods and contraceptive counseling
• Breastfeeding support, supplies, and counseling
• Domestic violence screening and counseling

See these links for more information:

www.hrsa.gov/womensguidelines/

www.hrsa.gov/womensguidelines/

www.healthcare.gov/center/regulations/prevention/taskforce.html

Please note that plans may impose cost sharing on brand name preventive drugs if a generic version is available and is just as effective and safe for the patient to use. Cost sharing would not be permitted on the generic drug.

Article Source: www.cigna.com/sites/healthcare_reform/index.html

The Internal Revenue Service has announced the 2012 contribution limits for health savings accounts (HSAs) and cost-sharing amounts for HSA-eligible, high-deductible health plans (HDHPs).

• Annual HSA contribution limits will be $3,100 for individual and $6,250 for family coverage. That is increased slightly from $3,050 for individual and $6,150 for family coverage in 2011.
• Maximum out-of-pocket expenses (deductibles, co-payments and co-insurance) for HSA-eligible health plans will be $6,050 for individual and $12,100 for family coverage. Those are also slight increases from the 2011 out-of-pocket maximums of $5,950 and $11,900 in 2011.
• A health plan must have deductibles of at least $1,200 for individual and $2,400 for family coverage in order to make participants eligible to open HSAs. Those are unchanged from 2011.

Source & More Information: http://www.hsabank.com/hsabank/Education/Limits.aspx.

There are some HSA plan changes currently being discussed in Washington D.C (in the form of S. 1098 & H.R. 2010).  They would allow some improvements to the current HSA laws such as:

• Giving spouses the chance to make catch-up contributions to the same HSA.
• Eliminating discriminatory provisions against Medicare-eligible seniors so that they can continue to contribute to their HSAs.
• Expanding the ability of individuals to purchase medical and long-term care insurance with HSA dollars.
• Clarifying that prescription drugs used for preventative care purposes are not subject to HSA deductible requirements.
• Allowing for FSA funds to be rolled over from year-to-year, to promote more responsible spending and allow individuals more choice in how they may use their FSA dollars.

For source & more information go here: http://capwiz.com/nahu/issues/alert/?alertid=50781501&queueid=7046206181.

As healthcare rates continue to rise, we’re seeing (and helping!) more & more companies make the switch to H.S.A. Plans. 

H.S.A. medical plans are high-deducible plans that typically cost a fraction of the cost of traditional plans.  In conjunction with a high-deductible medical plan, each employee can set up a tax-free Health Savings Account to pay for out-of-pocket health expenses.  This account may be funded by the employer, the employee, or both.

See this link if you’re interested in learning more about H.S.A. Plans: http://hsabank.com/hsabank/Education.aspx.

Please let us know if you’d like to see H.S.A. options at your next plan renewal!

As a result of federal healthcare reform, individual plans have changed their guidelines for adding children under the age of 19.  They can now be added at the following times only:

1. Open Enrollment Periods:           
   1. March 15th – April 30th, 2011 (for a May 1st effective date)
   2. September 15th – October 31st, 2011 (for a November 1st effective date)
   3. November 15th – December 31, 2011 (for a January 1st effective date)
2. Special Exceptions:  there are certain exceptions that allow children to be enrolled anytime during the year.  Parents must apply within 31 days of the following events to get coverage:
   1. No longer qualifying for a state program.
   2. Loss of coverage due to divorce.
   3. Loss of employer-sponsored coverage.
   4. Moved and current plan is not available at your new home.
   5. Also, parents/guardians can apply year-round within 60 days of birth, adoption, or placement of a child for adoption.

Feel free to contact us with any questions!  This is a change to the system which previously allowed dependents to be added at anytime with the completion of a health questionnaire.

For additional information, please see the WA Insurance Commissioner site: http://www.insurance.wa.gov/consumers/health/enrolling-children.shtml.