CalCPA ProtectPlus

The end of the calendar year marks the ProtectPlus annual open enrollment period. It’s also the time to make plan changes. For employees who opted not to enroll in ProtectPlus for whatever reason, this is another chance to join. For current subscribers it’s an opportunity to make changes in their coverage.

Maintaining the longer open enrollment period adopted in 2007, the Group Insurance Trust has announced that open enrollment begins on November 2 and ends December 31.

CalCPA member firms that haven’t offered ProtectPlus plans to their employees can, of course, enroll in Group Insurance Trust plans at any time.

Firms can consider the full range of offerings for 2010 that include;

• 5 copay plans
• 3 HSA-eligible plans
• 2 Anthem Blue Cross HMO plans

This is also the time of year that the Trust announces plan changes and premium adjustments. As always, premium  increases are anticipated with concern, but the good news is:

The Trust has been able to maintain its single digit  premium increases for the seventh consecutive year.

This is a remarkable achievement when you consider that ProtectPlus also beat industry averages in each of these years.

Several benefit improvements will be implemented in 2010.

• All ProtectPlus copay plans will see a reduction in the copay amount for generic prescription drugs from $15 to $10.
• Improved coverage for mental health and substance abuse services on all copay, HSA-eligible, and Anthem Blue Cross HMO plans.
• Medical plans will now align all mental health and substance abuse member cost-sharing provisions with those offered for in-network and out-of-network medical services and remove any visit limitations (in accordance with the Mental Health Parity and Addiction Equity Act of 2008).

The Trust will also combine several copay plans for 2010.
Last year the Trust offered eight copay plans, including both regular and enhanced versions of:

• Protect 15
• Protect 25
• Protect 35

The enhanced versions of these plans—which waive the deductible for the first six in-network office visits—proved so popular that trustees were persuaded to include the enhanced benefits as standard features in the copay plans at these levels.

For 2010 the Protect 15, Protect 25 and Protect 35 plans will all feature the enhanced benefit of six office visits that are not subject to the plan’s deductible, while the Protect 10 and Protect 45 plans will retain their original structure.

Vision Service Plan and Delta Dental rates will be restructured for 2010.
Going forward, rates for both plans will be based on firm size in much the same way the medical plan rates are structured.

• Effective January 1, 2010, firms with two or more participants will see a reduction in VSP and Delta Dental rates while others will note a small increase.

Changes in Premiums
Some ProtectPlus members will see changes in their premiums next year that reflect altered geographical rate bands. Anthem Blue Cross has re-aligned several zip codes in rate areas one, two, and three, and the Trust has followed its lead in order stay consistent. For some, these changes will mean lower than average premium increases, while for others, unfortunately, it may mean an increase in excess of the average overall premium increase.

[Image Source]

You can simply call Anthem Blue Cross customer service at 888-209-7847 or login to Anthem Blue Cross and click on Search for a Provider outside of California.

These tips are provided by “We Connect”

Consider COBRA (but act fast)
If you lose job-based coverage, you only have a short window to make decisions that affect your health insurance options. The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) and state law (Cal-COBRA) give workers and their families the right to continue group health benefits for at least 18 months, but only if they enroll within 60 days of losing their health coverage.

The Federal Government May Partially Offset the Cost
Usually, you’d have to pay your premium share, your former employer’s share, and an administrative charge to keep coverage under COBRA or Cal-COBRA. But if you lost job-based coverage after September 2008, the federal government will pay 65 percent of the cost of COBRA continuation coverage through December 2009.
Get Connected

Local Community Health Centers and Clinics Can Help
If you can’t afford or qualify for coverage, care is available through community health centers and other safety-net providers, which are located in most California communities.
Get Connected to locate a clinic near you. (continue reading…)

This update on the swine flu has been aggregated from the Center for Disease Control and Prevention Website. They are posting weekly updates that we will watch to keep you informed of the situation.

Key Flu Indicators
Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of August 30-September 5, 2009, a review of the key indictors found that influenza activity increased in the United States compared to the prior weeks. Below is a summary of the most recent key indicators:

• Visits to doctors for influenza-like illness (ILI) are increasing nationally. Visits to doctors for influenza-like illness are higher than what is expected during this time of year and have increased over the last four weeks.
• Total influenza hospitalization rates for adults and children are similar to or lower than seasonal influenza hospitalization rates depending on age group, but are higher than expected in the summer months. (continue reading…)

Care Comparison expands to cover all of California

All Anthem Blue Cross group members in California now have access to Anthem Care Comparison, our ground-breaking online tool that launched in 2008 to select geographic areas in the state. Care Comparison, provides total estimated costs associated will all aspects of nearly 40 specific mediacal procedures performed at local area hospitals and medical facilities.

Anthem Care Comparison is the only tool to bundle together related services and tests around a specific procedure typically costs.  And as our members will quickly see, one procedure can carry different price tags at different facitilites.  Those differences can increase or decrease members out-of-pocket costs. (continue reading…)

Employer Eligibility
ProtectPlus is available to accounting firms and firms offering general financial services. Solo practitioners (a CPA practicing on his/her own with no other employees) are eligible to apply.

To be eligible and retain such eligibility, more than 50% of all the Employer’s owners (i.e., principals, proprietors, partners, shareholders or other owners) must be CPAs or Associate members of CalCPA in good standing.

If you are a CPA and not a member of CalCPA, see how you can join CalCPA here.

All employers deemed to be part of an affiliated group under Internal Revenue Code Sections 414 (b), (c), or (m) are considered to be a single employer. (continue reading…)

Tax-Savings Can Really Add Up To Lower Healthcare Costs

Times are tough. Medical costs are on the rise. But there’s something you can do right now to get more for your healthcare dollars. Simply sign up for a CalCPA ProtectPlus Health Savings Account (HSA) plan and save big on the services you already use. HSA plans are available to any CalCPA ProtectPlus member whose employer is offering any of our three High Deductible Health Plans (HDHP).

With these accounts, you deposit pre-tax dollars into your Health Savings Account and then use your HSA debit card to pay for eligible medical expenses for you and your dependents. You can use your HSA for expenses like office visits, prescriptions, and emergency services, plus eligible expenses NOT covered by your plan such as dental, vision, many over-the-counter drugs and long-term care.

Get full details on HSA plans. See HSA eligible plans.

CalCPA Leadership Institute (this article was originally published by CalCPA)

Each year, CalCPA Leadership Institute teaches potential member leaders the specific skills necessary to grow into future leadership positions at CalCPA and in the profession.

Strong leaders in strategic positions are key to CalCPA’s continued success. CalCPA Leadership Institute is a five-day program designed to teach members skills that will make them better leaders and managers. Participants will grow as volunteer and business leaders as they focus on improving leadership behavior, as well as critical thinking and management skills.

The California CPA Education Foundation and CalCPA underwrite the costs except for a small administrative fee that is responsibility of the individual participant. Qualified candidates will be members who have the greatest potential for fulfilling future leadership roles at CalCPA. (continue reading…)

Having recently completed what looked like a paperwork endurance contest,  GIT staff and trustees were rewarded in  May when the Trust received a financial strength rating of B++ from insurance  company rating agency A.M. Best. In a press release announcing its positive evaluation, Best stated that the rating reflected the Trust’s “synergy with CalCPA, favorable level of capitalization and positive operating performance.”

The release went on to say that the Trust’s risk-adjusted capital position “remains favorable,” and is built upon “its historically positive operating results.” This gives a tremendous boost to all the GIT plans, affirming that they are as reliable as they are valuable.

Extended Rate Guarantee
On the heels of this good news, the Trust has announced that it will guarantee current 2009 premium rates for any newly enrolling firms through December 31, 2010. In terms of cost, there will never be a better time to switch to ProtectPlus than now. As CalCPA members you have available a variety of high quality health insurance plans that are already  competitively priced. By acting now, you and your employees can maintain current 2009 rates throughout 2010. Add to this the fact that ProtectPlus rate actions have averaged 7 percent over the past six years, which is significantly below average annual rate increases industry-wide,  and you should have all the incentives you need to enroll now. (continue reading…)

A note from Susan Young, Executive Director

Trust staff are frequently asked “why should I choose ProtectPlus?”  The short answer is, “because these plans provide valuable features you just aren’t going to find elsewhere.” At the top of the list is the claims advocacy that members get from the Seabury & Smith staff exclusively dedicated to serving Group Insurance Trust plan subscribers.

The Seabury staff usually resolves disputes and claims issues fast, despite the fact that they are often dealing with complicated issues. In an age when computer-processed claims are tossed out because they don’t fit the formula, having a live person to resolve problems can be a huge time saver.

A second, immensely important feature of ProtectPlus is the right of survivors to continue coverage. In plain terms this means that if a member dies, his or her dependents can continue their health coverage as long as they need it—either until they qualify for Medicare, remarry, or get other coverage through an employer.

Finally, ProtectPlus allows college students between the ages of 19 and 25 to remain on their parents’ plans if they carry a minimum of nine units. The industry standard for this benefit is 12 units. Additionally, dependents between the ages of 19 and 25 who may be taking time off from school or serving on a HSAsreligious mission may remain in the plan as “single-subscribers” billed at their own age rate, until they once again qualify as a dependent student, become independent of their parents, or turn age 25.

The American Recovery and Reinvestment Act of 2009 (ARRA), signed into law in February, offers significant health insurance benefits to all those who are involuntarily terminated from a job between September 1, 2008 and December 31, 2009.

If you lose or have lost work during this period, you need to know about these provisions because they can save you money. Keep in mind, however, that if you voluntarily quit your job you don’t qualify. Moreover, individuals who were fired for negligence or misconduct don’t qualify either.

If you are an employer and let employees go during these 15 months, new rules under this law require action on your part. Among its many features, ARRA provides federal subsides that reduce premiums for nine months of COBRA or Cal-COBRA coverage.

During this nine-month period eligible individuals (and their qualified beneficiaries) are responsible for only 35 percent of their premiums. For COBRA recipients the remaining 65 percent must be paid by their former employer, while for Cal-COBRA recipients, the 65 percent portion must be paid by the insurer. Employer and insurer payments, however, are fully reimbursable through a tax credit.

Another provision of the new law allows COBRA recipients to switch their health coverage to a less expensive policy if that policy is available to all active employees of their former company.

Under the previous law, an eligible employee could only elect to continue coverage under the policy they had at the time they were terminated. To comply with ARRA, employers must amend their existing COBRA notice forms and distribute additional notices that include information about these benefits. (continue reading…)

Ensure access to quality, affordable coverage

Congress has begun to debate how to reform our nation’s health care system, and it is important for them to hear from you. It is an historic opportunity to enact comprehensive reform that makes health care more affordable, improves quality and covers all Americans.

We strongly support reform that builds a strong, sustainable private-sector health care system – and strongly oppose creating a government-run health plan. We are urging our elected officials in Washington to take bipartisan action that will accomplish that. We are educating policymakers in Washington and working with our trade associations to encourage Congress to build on the current system and not disrupt the quality, affordable coverage on which our members depend.

Our elected officials need to hear from you

There is a role that you can play in this effort, too. As our elected officials debate health care, they need to hear directly from you. You understand the important role that private-sector health plans play in ensuring access to quality, affordable coverage.

Surveys show that the American people support a common-sense approach in which the public and private sectors work together to fix the health care system. We agree. Nonetheless, there are proposals in Washington that would threaten our ability to continue serving individuals, families and employers. We cannot allow that to happen.

That is why it is important for you to get involved in our grassroots effort. Here are some steps that you can take to get involved in the health care reform debate and to ask others to participate as well. (continue reading…)

Comprehensive healthcare, with simple administration.  We know that your time is limited and you have enough to do just keeping your firm running smoothly. The last thing you need standing between you and billable hours is more work shopping for healthcare options and then investing even more time administering a plan. But, there’s an easier way to provide your firm with quality healthcare at affordable rates.

ProtectPlus, makes it simple for small firms to provide comprehensive healthcare to their employees with easy one-stop shopping for plans that include medical, dental, vision, disability and life insurance. And, we make it even easier by providing back office assistance–so administration of your benefits is a breeze.

With ProtectPlus, your CalCPA firm can get exclusive programs and coverage ordinarily available only to larger firms. Our group plans include the best doctors, hospitals and administrators available at competitive rates. Additionally, our staff is responsive and delivers personalized service you won’t get anywhere else.

Since we offer programs only to CalCPA member firms, we understand the unique needs of your business. Our plans are specifically designed just for CPAs, so you’ll find the perfect program for your business.

And if you thought you needed more staff to administer a healthcare plan, think again. So you can stay focused on your core business, ProtectPlus provides back office services that include:

• CalCobra administration and billing
• Employee eligibility assistance
• Help with completing forms
• Billing and collection of premiums
• Answering employee’s questions about plan benefits
• Facilitating claims resolution

Get comprehensive coverage for your firm from the people that know your needs and understand your business. Click here to receive an instant, no-obligation quote now.

As a solo practitioner, you’re in great company. When it comes to healthcare, being a solo practitioner doesn’t mean going it alone.

With ProtectPlus, you can take advantage of the comprehensive coverage and competitive rates of a group plan. We make it simple for solo practitioners to get superior healthcare with the ease of one-stop shopping for plans that include medical, dental, vision, disability and life insurance.

With ProtectPlus, your one-person firm can get exclusive programs and coverage ordinarily available only to large firms, with group plans that include the best doctors, hospitals and administrators available. Additionally, our staff is responsive and delivers personalized service you won’t get anywhere else. Since we offer programs only to CalCPA member firms, we understand the unique needs of your business. Our plans are specifically designed for CPAs, by CPAs, so you’ll find the perfect program that fits you. (continue reading…)

This Survey via Pew Internet & American Life Project

OVERVIEW

Americans’ pursuit of health takes place within a widening network of both online and offline sources. Whereas someone may have in the past called a health professional, their Mom, or a good friend, they now are also reading blogs, listening to podcasts, updating their social network profile, and posting comments. And many people, once they find health information online, talk with someone about it offline.

This Pew Internet/California HealthCare Foundation survey finds that technology is not an end, but a means to accelerate the pace of discovery, widen social networks, and sharpen the questions someone might ask when they do get to talk to a health professional. Technology can help to enable the human connection in health care and the internet is turning up the information network’s volume.

ABOUT THE SURVEY

The findings in this report come from a national phone survey done by the Pew Research Center’s Internet & American Life Project in partnership with the California HealthCare Foundation. Some 2,253 adults, age 18 and older, were interviewed in December 2008 about the social impact of the internet on health care. The interviews were conducted in English or Spanish and included 502 cell-phone interviews.

Read Full Report

This is Part 3, of a three part article.  For Part 2, see Employers, What You Need to Know About the Federal Stimulus Package: Part 2.

This article was written by Connie Chuang and Gage C. Dungy, attorneys with the labor and employment law firm of Liebert Cassidy Whitmore.

In the beginning, some covered individuals may not become aware of the new federal subsidy and therefore continue to overpay their COBRA/Cal-COBRA premiums by paying the full premium amount.  In order to reimburse the covered employee in this situation, employers will have an initial choice of either providing a refund or a credit to be used against future premium  payments.  The credit option is only available if it is expected that the full credit will be used by the individual within 180 days of the date the full COBRA premium amount was paid. (continue reading…)

Responding to the growing popularity of Health Savings Account eligible medical insurance plans (commonly referred to as HSAs), the Group Insurance Trust (CPA ProtectPlus) has expanded its current offerings with a third such plan, Protect HSA $2,500.

With premiums approaching the lower end of ProtectPlus co-pay plans, the new plan offers significantly greater benefits than the two already established Protect HSA plans.

As with all HSA-eligible plans, Protect HSA$2,500 features a high annual deductible that must be satisfied before benefits are paid by the plan. For the new plan the deductible is $2,500 per individual and $5,000 per family.

Though not greatly different from HSA $2,850 in respect to the deductible, the difference in benefits is large indeed.

After the deductible is met HSA $2,500 provides 100 percent coverage for all in-network office visits, professional services, emergency and in-patient hospitalization, hospital and outpatient surgery, lab costs and more.

It also pays 70 percent of the negotiated fee for all these services when provided out-of-network. In contrast, HSA $1,500 and $2,850 pay 70 percent of negotiated fees for in-network services and 50 percent of negotiated fees out-of-network. (continue reading…)

(This News Article via California Healthline June 26th, 2009)

California clinics this week lost their court battle against the state’s plan to eliminate funding for adult dental care and several other services.

A Sacramento County Superior Court judge ruled that the state Legislature had the right to cut adult Denti-Cal and other benefits when it voted in February on various measures to reduce state spending. A lawsuit filed in April by the California Primary Care Association and two clinic groups argued that eliminating some Medi-Cal benefits, including adult Denti-Cal, violates federal law.

Denti-Cal is the dental benefit provided through Medi-Cal, California’s Medicaid program.

The suit, aimed at preventing the state from ending Medi-Cal payments for services at federally qualified health centers and rural health centers, claimed that state and federal law requires such centers to provide dental care and other services to all residents, regardless of income.

Reimbursements for dentistry, optometry, podiatry and chiropractic programs is scheduled to stop July 1, as is funding for other optional Medi-Cal benefits, including speech therapy and some mental health services.

Clinicas del Camino Real, a group of 10 clinics for low-income people in Ventura County, filed the lawsuit along with Southern Trinity Health Services in Northern California and the statewide California Primary Care Association, which represents hundreds of clinics throughout the state.

Officials for Clinicas del Camino Real said the loss of Medi-Cal reimbursements could result in layoffs of as many as 150 people and the closure of two of its clinics.

California lawmakers are taking a closer look at Medi-Cal spending as they work to address the state budget deficit. Here’s a look at other legislation under consideration in Sacramento.  Continue to original source.

This article was written by Connie Chuang and Gage C. Dungy, attorneys with the labor and employment law firm of Liebert Cassidy Whitmore.

The Federal Stimulus Package Incorporates New Temporary Revisions to COBRA/Cal-COBRA, Including a Federal Subsidy for Qualified Individuals.

Federal law (COBRA – employers with 20 or more employees) and California law (Cal-COBRA – employers with 2-19 employees) provide individuals who have experienced a “qualifying event” the ability to continue their health insurance benefits for a period of up to 36 months by having the covered individual pay up to 102% of the full health insurance premium cost.

A “qualifying event” under COBRA/Cal-COBRA includes, among other reasons, voluntary termination of employment, involuntary termination of employment (except for gross misconduct), and a reduction in hours resulting in a loss of health benefits.

On February 17, 2009, President Barack Obama signed into law a federal stimulus package – also known as the “American Recovery and Reinvestment Act of 2009” – (or, visit Recovery.gov)in an attempt to address the current economic downturn in the United States. (continue reading…)

(Originally published by Anthem Blue Cross April 24,2009)

The new CalCOBRA legislation, California Assembly Bill 23, is expected to be signed by the Governor by the end of this week. This bill will align the current CalCOBRA legislation with the Federal Subsidy as defined by ARRA (American Recovery and Reinvestment Act). The following are high-level details you should be aware of:

• This bill states that health plans and health insurers have 14 days from the date of enactment to provide proper notification to those individuals who may qualify for the Cal-COBRA subsidy. The Department of Labor (“DOL”) has agreed that the timeliness within which the state mini-COBRA programs must comply is to be determined by the states themselves. The DOL held a call with the California Department of Insurance (“CDI”) and the Department of Managed Health Care (“DMHC”) to assure this is understood by all three regulators.
• The mailing will go out to all individuals who had a qualifying event between Sept. 1, 2008, to the present, regardless of whether or not they had already elected CalCOBRA.
• The bill (AB23) currently states that California residents who were involuntarily terminated from their jobs between Sept. 1, 2008, and the present will qualify for the Cal-COBRA special election period.
• There is a notice letter being developed by Anthem in conjunction with the California Association of Health Plans (“CAHP”) and other health plans in this state. Once finalized, this notice will be deemed approved by both the CDI and DMHC. Anthem will send the notice as soon as possible following the enactment of AB 23.
• Once the bill is finalized and signed into law, Anthem will share a more detailed summary of the specific provisions of this law.

To continue reading “In the Interim“