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February 3, 2012 is National Wear Red Day – a day that Americans learn about and reflect on the dangers of having an unhealthy heart and wear read in support for women’s heart disease awareness. Back in 2004, the American Heart Association (AHA) knew they had work to do when cardiovascular disease claimed the lives of nearly 500,000 each year. People were not seeing the seriousness of having a healthy heart and knowing what the warning signs were. It was because of this that the American Heart Association created Go Red For Women which was a way to present the facts and provide women with the knowledge and tools they need to take care of their hearts.

With heart disease continuing to be the number one killer of women – 1 in 3 deaths each year, it is no wonder why the American Heart Association is so passionate about getting their message out about heart health. Below you will find valuable information from the American Heart Association’s Go Red For Women website that spells out the warning signs of a heart attack in women. It is very important to educate yourself on how to have a healthy heart because you may save not only your own life but you can help your friends and family as well.

Overview

More women die of cardiovascular disease than from the next four causes of death combined, including all forms of cancer. But 80 percent of cardiac events in women could be prevented if women made the right choices for their hearts involving diet, exercise and abstinence from smoking. Make it your mission to learn all you can about heart attacks and stroke — don’t become a statistic. CALL 9-1-1

Heart Attack

A heart attack occurs when the blood flow to a part of the heart is blocked, usually by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die.

Signs of a Heart Attack:

1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
3. Shortness of breath with or without chest discomfort.
4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

If you have any of these signs, don’t wait more than five minutes before calling for help. Call 9-1-1…Get to a hospital right away.

Stroke

Stroke is the No. 3 cause of death in America. It’s also a major cause of severe, long-term disability. Stroke and TIA (transient ischemic attack) happen when a blood vessel feeding the brain gets clogged or bursts. The signs of a TIA are like a stroke, but usually last only a few minutes. If you have any of these signs, don’t wait more than five minutes before calling for help.

Call 9-1-1 to get help fast if you have any of these, but remember that not all of these warning signs occur in every stroke.

Signs of Stroke and TIAs

1. Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
2. Sudden confusion, trouble speaking or understanding
3. Sudden trouble seeing in one or both eyes
4. Sudden trouble walking, dizziness, loss of balance or coordination
5. Sudden severe headache with no known cause

Also, check the time so you’ll know when the first symptoms appeared. It’s very important to take immediate action. Research from the American Heart Association has shown that if given within three hours of the start of symptoms, a clot-busting can reduce long-term disability for the most common type of stroke.

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A recent study, published in The Lancet, shows that in order to get an accurate blood pressure reading, doctors should take the patient’s blood pressure in both the right and left arm. The findings showed that there was a difference in systolic blood pressure between the two arms – about 15 milimeters of mercury (mm Hg). This difference in the blood pressure is linked to an increased risk of peripheral artery disease (PAD) which is a condition where there is a narrowing of the arteries, especially in the legs and feet. The 15 millimeters difference of mercury in the two arms means the individual is 2.5 times more likely to have PAD and the risk of cerebrovasular disease is 1.6 times higher. It was also associated with a 70% greater risk of dying from heart disease.

The Lancet study brings out the fact that there already is an existing guideline for doctors showing that they should always take blood pressure readings from both arms. Dr. Christopher Clark, the lead author in the study said,  ”Recommendations to measure both arms exist in both British and American blood pressure managment guidelines.” He goes on to say, “This is out there as guidance, but it’s guidance that isn’t regularly followed.” A difference of just 10 millimeters was enough to raise the risk of peripheral vasular disease so having the difference of 15 millimeters should be enough to make more doctors pay attention to the guidelines.

Why would there be a difference in readings between the two arms? The authors of the study hypothesized that it could be the narrowing or hardening of a person’s arteries, especially on one side of their body.

Dr. Clark said, “If we don’t know to measure both arms, we’re not going to make the right diagnosis and the right treatment choices for our patients.” Since many doctors only measure one arm, the next time you visit your doctor, make sure to remind them to take your blood pressure readings in both arms. By doing this you are ensuring that you will receive the most accurate readings and more likely a correct diagnosis.

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Banyan Administrators continues to provide us with beneficial information about several different aspects of the Health Care Reform and how it affects us. Over the next months and years, employers will be faced with numerous changes, many of which require regulatory clarification. Banyan will continue to keep us up to date and on target with decisions that affect our plans.

The following information is from Banyan Administrators:

News

W2 Reporting IRS Releases Notice 2012-09

On January 2, 2012, the IRS released Notice 2012-09 which updates and amends Notice 2011-28 regarding the reporting of employer-sponsored group health plan on the 2012 W-2 Forms as required by the Health Care Reform Act.  Notice 2012-09 does not change the reporting requirement for employers, but, does provide additional guidance and clarification on certain topics.  Some highlights of the new Notice includes: 

• Clarification of the interim relief reporting requirement for employers filing fewer than 250 Forms W-2.
• The cost of coverage for employee assistance programs (EAP), wellness programs, or on-site medical clinics do not have to be reported if the employer does not charge a premium with respect to that type of coverage provided under COBRA to a qualifying beneficiary.
• Employers may include the cost of coverage for benefit programs, such as Health Reimbursement Accounts, that are excluded from the reporting requirement and clarification on how to calculate the cost.
• Clarification on other unique situations such as if a pay period extends over the end of the tax year on December 31^st, if a composite rate is charges for active employees but not for COBRA qualified beneficiaries, if certain related employers are not using a common paymaster, etc. 

To view IRS Notice 2012-09, please click here.

Health Care Reform W2 Reporting Interim Final Rules

What You Need to Know Now About: W-2 Reporting

On March 31, 2011, the Internal Revenue Service (IRS) released the 19-page Interim Final Rules on the Health Care Reform W-2 reporting requirements. The IRS is still taking comments on the rules for the next 60 days. 

1.       What needs to be reported on the W-2 form?

Employers must report the costs for a group health plan. This does not include dental and vision plans unless the plans are integrated in the group health plan. Disability and long term care plans are also excluded from the reporting requirement.

2.       How do I determine the cost for the group health plan?

The cost includes both the employee contribution and employer contribution. Employers with fully-insured health plans should use the monthly premium rate. Employers with self-funded health plans should use the COBRA premium equivalent rates less the 2% administrative fee. Employer contributions into Medical Savings Accounts (MSA), Health Savings Accounts (HSA), Health Reimbursement Accounts (HRA) and, in most instances, Flexible Spending Accounts (FSA) are excluded.

3.       Where do I enter this information on the W-2 Form?

The information is entered in Box 12 on the W-2 form using code DD.

4.       Will the amount be included as taxable income for my employee?

No it will not. The first page, first bullet of the IRS Interim Final Rules state, “This reporting to employees is for their information only, to inform them of the cost of their health care coverage, and does not cause excludable employer-provided health care coverage to become taxable.”

5.       When do I have to be ready to comply with the new W-2 reporting requirement?

If you issue more than 250 W-2 forms for tax year 2011, you are required to comply with the new requirement for the 2012 tax year W-2 forms that are distributed to employees in January, 2013. You do have the option to comply earlier, if desired. However, remember that a terminating employee in calendar year 2012 can ask for an early W-2 so, in reality, you will need to be ready to comply as early as January, 2012.

Employers that issue 250 or fewer W-2 forms for tax year 2011 can receive “transition relief” from this requirement until January, 2014.

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World AIDS Day began in 1988 and is observed December 1 each year with the purpose is to raise awareness of the AIDS caused by the spread of HIV infection. It is recognized by political figures and health officials worldwide. On November 8th, Secretary of State Hillary Rodham Clinton spoke about her goal for an “AIDS Free Generation”. You can view this speech by visiting PEPFAR or by clicking here to go directly to the video. Since 1995, the President of the United States has given an official speech on World AIDS Day. To read the proclamation that President Barack Obama gave earlier today, click here.

This year the theme for World AIDS Day 2011 is ‘Getting to Zero’. According to unaids.org, this year the global community has committed to focusing on achieving 3 targets: “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths”.  With stats like the following ones from unaids.org, it is crucial that we increase our awareness and seek out what we can do as individuals to help.

At the end of 2010 an estimated:

• 34 million [31.6 million – 35.2 million] people globally living with HIV
• 2.7 million [2.4 million – 2.9 million] new HIV infections in 2010
• 1.8 million [1.6 million – 1.9 million] people died of AIDS-related illnesses in 2010

On November 30, 2011, a report by the WHO, UNICEF and UNICEF and UNAIDS Global Report on the global HIV/AIDS response showed that having increased access to HIV services resulted in a 15% reduction of new infections over the past decade and a 22% decline in AIDS-related deaths in the past five years.

“It has taken the world ten years to achieve this level of momentum,” says Gottfried Hirnschall, Director of WHO’s HIV Department. “There is now a very real possibility of getting ahead of the epidemic. But this can only be achieved by both sustaining and accelerating this momentum over the next decade and beyond.”

The report highlights what steps have been working to combat AIDS:

• Improved access to HIV testing services enabled 61% of pregnant women in eastern and southern Africa to receive testing and counseling for HIV – up from 14% in 2005.
• Close to half (48%) of pregnant women in need receive effective medicines to prevent mother-to-child transmission of HIV (PMTCT) in 2010.
• Antiretroviral therapy (ART), which not only improves the health and well-being of the infected people but also stops further HIV transmission, is available now for 6.65 million people in low- and middle-income countries, accounting for 47% of the 14.2 million people eligible to receive it.

The report brings out what steps still have to be taken:

• More than half of the people who need antiretroviral therapy in low- and middle-income countries are still unable to access it. Many of them do not even know that they have HIV.
• Despite the growing body of evidence as to what countries need to focus on to make a real impact on their epidemics, some are still not tailoring their programmes for those who are most at risk and in need. In many cases, groups including adolescent girls, people who inject drugs, men who have sex with men, transgender people, sex workers, prisoners and migrants remain unable to access HIV prevention and treatment services.

Other sites to visit to learn more about World Aids Day and what you can do to help:

http://www.worldaidscampaign.org/

http://www.unaids.org

http://www.avert.org/world-aids-day.htm

http://www.youtube.com/theonecampaign

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On September 13, 2011, a national initiative was announced by Million Hearts to prevent 1 million heart attacks and strokes over the next 5 years. Since one in three deaths occur in the United States due to heart disease, it is vital that we educate ourselves on the terrible disease. Over the next few months we will feature articles that will help educate readers on what heart disease is, as well as what cardiovascular disease and strokes are. We hope our readers will be able to learn what causes these conditions and what they can do to help prevent them.

The following is taken from http://millionhearts.hhs.gov.

Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over the next five years. The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services are the co-leaders of Million Hearts within the U.S. Department of Health and Human Services, working alongside other federal agencies including the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Food and Drug Administration. Key private-sector partners include the American Heart Association, and YMCA, among others.

Heart disease and stroke are two of the leading causes of death in the United States. Million Hearts aims to improve heart disease and stroke prevention by:

• Improving access to effective care.
• Improving the quality of care.
• Focusing more clinical attention on heart attack and stroke prevention.
• Increasing public awareness of how to lead a heart-healthy lifestyle.
• Increasing the consistent use of high blood pressure and cholesterol medications.

Million Hearts brings together existing efforts and new programs to improve health across communities and help Americans live longer, healthier, more productive lives.

• Learn more about the science of Million Hearts in CDC’s Morbidity and Mortality Weekly Report
• Check out Million Hearts in Circulation, [PDF-286K] a journal of the American Heart Association
• See the Million Hearts perspective in the New England Journal of Medicine
• See the Million Hearts press release issued on Tuesday, September 13, 2011 [PDF-132K]

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Banyan Administrators continue to provide us with beneficial information about several different aspects of the Health Care Reform and how it affects us as well as other interesting health care facts. Over the next months and years, employers will be faced with numerous changes, many of which require regulatory clarification. Banyan will continue to keep us up to date and on target with decisions that affect our plans.

The following information is from Banyan Administrators, LLC:

What You Need to Know About: Enhanced Women’s Preventive Services

On 7/14/2010, the Department of Health & Human Services (HHS) released the list of A and B services determined by the US Preventive Services Task Force. These preventive services were categorized by adult, women and pediatric services. In the Department of Labor’s (DOL) Interim Final Rules released on 7/19/2010, the DOL also stated that additional preventive services for women were still being debated for inclusion. On 8/1/2011, the DOL issued Interim Final Rules on Enhanced Women’s Preventive Services resulting in considerable media coverage particularly concerning oral contraceptives now being payable with no cost share, such as a copay. However, the actual implementation of the new preventive services provisions is more complicated and the rules are still subject to change.

1.  Does this health care reform provision apply to “grandfathered” plans?

No, grandfathered plans do not need to comply with this provision. If, in the future, your health plan loses its grandfathered status, this reform will apply to your plan.

A grandfathered plan can voluntarily choose to comply with the provision and when the 2010 list of preventive services were released in July, 2010, some grandfathered plans did choose to comply and provide some, if not all, of the preventive services on the list with no cost share to the participant. The DOL rules for enhanced women’s preventive services does not address this scenario so the opinion is that a grandfathered health plan can still voluntarily decide to provide some, or all, of the services listed with no cost share to the participant.

2.  What are the enhanced women’s preventive services?

In addition to the 15 women’s preventive services issued on 7/19/2010 that included anemia screenings, mammography screenings, cervical cancer screenings, etc., 8 additional preventive services have been added:

• Well-woman visits, annually
• Gestational diabetes screenings for pregnant women between 24 and 28 weeks of gestation and at first prenatal visit for pregnant women at high-risk of diabetes
• Human papillomavirus testing beginning at age 30 and no more frequently than once every 3 years
• Counseling for sexually transmitted infections, annually
• Counseling and screening for HIV, annually
• Contraceptive methods and counseling, as prescribed
• Breastfeeding support, supplies and counseling in conjunction with each birth
• Screening and counseling for interpersonal and domestic violence, annually (continue reading…)