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.

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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.

County-sponsored Programs for Adults
Uninsured single adults who are not eligible for Medi-Cal may qualify for the County Medical Services Program (CMSP) providing health coverage for low-income, indigent adults in 34, primarily rural counties in California.
Get Connected

Hospitals Must Treat Your Emergency
Federal law requires that all hospitals treat and stabilize any patient experiencing a medical emergency, regardless of a patient’s ability to pay.

Coverage for Kids
Parents should consider coverage for their children through public insurance programs such as Medi-Cal and California Children’s Services (CCS).
Get Connected and find out what programs are available.

For Moms and Children
Access for Infants & Mothers (AIM) and Women-Infant-Children (WIC) offer special health care services to women and infants in need.
Get Connected AIM or 800.433.2611

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.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was low and within the bounds of what is expected in the summer.
• Eleven states (Alaska, Arizona, Florida, Georgia, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, and Tennessee) and Guam are reporting widespread influenza activity at this time. Any reports of widespread influenza activity in August and September are very unusual.
• Almost all of the influenza viruses identified were 2009 H1N1 influenza A viruses. These 2009 H1N1 viruses remain similar to the viruses chosen for the 2009 H1N1 vaccine, and remain susceptible to antiviral drugs (oseltamivir and zanamivir) with rare exception.

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.

Quality information is also included so members cn access information regarding the number of patients treated, complication rates, average length of stay and mortality rates.

All of the information provided is easy to find and easy to understand.

Members can become engaged health care consumers when they use Antheme Care Comparison as well as the Zagat Health Survey, whihc allows members to view or sublmit feedback on their experiences with physicians on the following four categories:

1. Trust: Confidence in physician’s approach, integrity and recommendations
2. Communication: Physician’s bedside manner, responsiveness and rapport with patients.
3. Availability: Convenient appointments, physician’s punctuality and face-to-face time.
4. Environment: Office condition, staff quality, atmosphere and amenities.

Anthem Care Comparison and Zagat Health Survey are two of the many online tools available when you visit anthem.com/ca and login into member services.

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.

Employee Eligibility
Active, regular full-time solo practitioners working at least 20 hours per week are eligible for coverage.

Dependent Eligibility
Eligible dependents include a lawful spouse, domestic partner, and unmarried children, up to age 19, or through age 24 if the child is an unmarried, full-time student carrying nine or more credit hours per semester. Disabled children of eligible employees who, with appropriate medical certification, are eligible for coverage at any age. Children of domestic partners are eligible. Non-student dependent children, ages 19 through 24, are eligible but must be covered at employee rates.

Learn More

CalCPA ProtectPlus Copay Plans

CalCPA ProtectPlus HSA Plans

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

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.

Sample Topics
CalCPA Leadership Institute participants will discuss, among other topics:

• Fundamentals of leadership
• Identifying personal leadership styles
• Strategic planning and goal setting
• Client management
• Managing people

Visit CalCPA to download 2009–10 application and learn more.

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.

Coordinating Benefits
ProtectPlus subscribers will occasionally receive a letter and questionnaire from Anthem Blue Cross asking if you have any other health coverage. For those who do, please be aware that the questionnaire will be used to determine what portion of your bills should be paid by ProtectPlus  and what portion by the other insurer. It is very important that you respond to this letter whether or not you have other coverage. If you have no other health insurance, you can simply call (800) 227-3641 and let Anthem know. If you do have other insurance, fill out the form and return it. In either case, do not delay because claims will not be processed until the form is returned or Anthem has been advised that no other coverage exists.

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.