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Category: Health Reform

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TN Plans Encouraged to Give "Good Driver Discounts"

Proposed recommendations for the Tennessee Health Insurance Exchange encourage health plans and employers to establish expectations about personal responsibility and engagement through benefit designs in the Exchange.   The wellness program could provide some sort of "good driver discount" in the form of a lower premium or other incentives to those enrollees who satisfy these standards. Having the exchange plans offer these incentives will make it easier for larger employers too!... Read More
Posted by Cristie Travis at Monday, December 12, 2011

How Will a TN Insurance Exhcange Impact Employers?

Get the answer by reading the full document (or the Executive Summary ), “Best Alternatives to a Federal Insurance Exchange in Tennessee”, just issued by the State of Tennessee Insurance Exchange Planning Initiative (the Initiative). The report provides a comprehensive analysis of the governance, structure, processes of an insurance exchange and suggests how Tennessee may want to address the issues to ensure a stable and competitive market in the state. The Small Business... Read More
Posted by Cristie Travis at Monday, October 31, 2011

IOM's Essential Health Benefits Recommendations Leave More Questions Than Answers

The IOM recommended that HHS develop an EHB package by May 2012. The high-level recommendations are as follows: 1. The EHB package should be adjusted so that the expected national average premium for a “silver” (second-lowest-price) plan is actuarially equivalent to the average premium small employers would have paid in 2014 for a typical plan. 2. The HHS Secretary should establish a framework for monitoring EHB implementation and updating that accounts for changes in... Read More
Posted by Cristie Travis at Thursday, October 20, 2011

Do You Understand the Impact of the Individual Mandate?

Great article from Milliman explaining why something has to be done to address adverse selection in health reform. If it is not the individual mandate, what will it be? As Tom Snook, Principal & Consulting Actuary, Milliman Inc., says, people will operate in their own economic self-interest. If they are healthy and the cost of health insurance is high, they will not purchase health insurance, especially if it is not highly subsidized by their employer. If they are sick, they are more... Read More
Posted by Cristie Travis at Thursday, September 22, 2011

Rules Issued for Women's Preventive Care

On August 1, the Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) issued detailed guidelines ( http://www.hrsa.gov/womensguidelines/ ) for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA). A fact sheet is also available at the HealthCare.gov portal. These guidelines supplement the IFR on general preventive care requirements... Read More
Posted by Cristie Travis at Monday, September 19, 2011

Tax Treatment of Employer-Provided Health Coverage

Currently, the value of health insurance coverage provided by employers is not subject to payroll or income taxes. Recent budget calculations indicate that this is the federal government’s largest tax expenditure, at a cost of more than $1 trillion over the next five years (though this also includes the employer deduction of these costs as a business expense), and the Joint Tax committee has estimated the cost of the tax expenditure for the employee exclusion for health insurance... Read More
Posted by Cristie Travis at Monday, September 19, 2011

McKinsey Projects 30% of Employers Will Drop Health Benefits

Major findings from McKinsey's early 2011 survey of 1,300 employers include: Overall, 30 percent of employers will definitely or probably stop offering employer-sponsored insurance (ESI) in the years after 2014. Among employers with a high awareness of reform, this proportion increases to more than 50 percent, and upward of 60 percent will pursue some alternative to traditional ESI. At least 30 percent of employers would gain economically from dropping coverage even if... Read More
Posted by Cristie Travis at Monday, June 6, 2011

IRS Releases 2012 Indexed Amounts for HSAs, HDHPs

On May 24, 2011, the U.S. Treasury Department and Internal Revenue Service (IRS) released Revenue Procedure 2011-32, which lists the 2012 indexed amounts, adjusted for inflation, for health savings accounts and high-deductible health plans (HDHPs). (In some cases, this resulted in no change from the prior year.) The following table lists the 2011 amounts and the new 2012 amounts: The Revenue Procedure is effective for calendar year 2012.  (Source: CQ HealthBeat) ... Read More
Posted by Cristie Travis at Tuesday, May 31, 2011

Delbanco believes the healthcare payment system needs “CPR”

Who better to help you beat the health reform blues than Suzanne F. Delbanco, PhD., executive director of Catalyst for Payment Reform (CPR). Delbanco is joining Peter Hayes , Principal for Healthcare Solutions and formerly with Hannaford Supermarkets, and John Moses, PhD, thought leader for behavior change and measurement with AON Hewitt, as national keynote speakers at MBGH September 8, 2011 Annual Conference, “Got the Health Reform Blues?” .   CPR is working to... Read More
Posted by Cristie Travis at Monday, May 16, 2011

MBGH Appointed to National Measures Applications Partnership Advising HHS

Memphis Business Group on Health has been appointed to the Measures Applications Partnership (MAP), a consensus-based entity advising the U. S. Department of Health & Human Services (HHS) on the best measures to use in public reporting, value-based payment, and other programs. Established by the National Quality Forum, the MAP brings together stakeholder groups in collaboration that balances the interests of consumers, businesses and purchasers, labor, health plans, clinicians and... Read More
Posted by Cristie Travis at Monday, May 16, 2011

Broker Commissions: In or Out of Medical Loss Ratio Calculations?

Health Reform Update from the National Business Coalition on Health The National Association of Insurance Commissioners (NAIC) is considering whether to endorse legislation that would remove broker and agent commissions from the medical loss ratio, a calculation that could give consumers valuable insights about the proportion of their premiums spent on health care costs compared with administrative expenses and salaries. Removal would have far-reaching implications for the... Read More
Posted by Cristie Travis at Wednesday, May 11, 2011

High-Profile Healthcare Centers Skeptical of ACO Proposed Rules

Health Reform Update from National Business Coalition on Health As NBCH and many organizations are preparing to submit comments to HHS on the ACO federal regulations, the nation’s highest-profile health care centers — the Cleveland Clinic, the Mayo Clinic, Intermountain Healthcare or the Geisinger Health System —have so many concerns with the proposed rule to create ACOs that they doubt that they will participate. The 2010 health care law (PL 111-148, PL 111-152) created the... Read More
Posted by Cristie Travis at Wednesday, May 11, 2011

MBGH is First TN Employer Group to Sign Pledge for Partnership for Patients

Memphis Business Group on Health is the first employer/employer group in Tennessee to sign the pledge to support the " Partnership for Patients ' Partnership for Patients: Better Care, Lower Costs was launched today, April 12, 2011, by HHS Secretary Sebelius and CMS Administrator Berwick along with consumer groups, industry representatives, and other key stakeholders, including the Leapfrog Group and the National Business Coalition on Health. MBGH was the first Tennessee employer group... Read More
Posted by Cristie Travis at Tuesday, April 12, 2011

Are Memphis Employers Kinder & Gentler?

Are Memphis Employers Kinder and Gentler Than Their National Counterparts?   MBGH decided to find out. We separated out the responses of Tennessee employers to a national survey of employers and then compared them to national responses.  Most of the Tennessee respondents were from Memphis, giving us insight into what Memphis employers are thinking and doing! And, it's surprisingly different. Take a quick look at these easy-to-read findings. Read More
Posted by Cristie Travis at Sunday, March 20, 2011

Brokers Seek to Preserve Role in Health Insurance Exchanges: TN Update

Insurance brokers, concerned that their livelihoods could be significantly impacted with the implementation of health insurance exchanges, are working hard to be sure they continue to play a role and earn agent commissions. Efforts include working with the National Association of Insurance Commissioners to get Congress to exempt broker/agent commissions from the medical loss ratio requirements; introducing a bill in Iowa that requires individuals and small employers to use a broker to... Read More
Posted by Cristie Travis at Wednesday, March 16, 2011

MBGH to Moderate Mid-South's Healthiest Employers Panel

Cristie Upshaw Travis, CEO of Memphis Business Group on Health, will moderate a panel discussion on health issues that affect the workplace after the awards breakfast for the Mid-South's Healthiest Employers on Friday, March 25, 2011. The Mid-South's Healthiest Employers awards are presented by the Memphis Business Journal, partnered with The Church Health Center, and sponsored by CIGNA, the Y, and Methodist Healthcare. The awards breakfast will recognize local, Memphis-area employers for... Read More
Posted by Cristie Travis at Monday, February 14, 2011

MBGH Talks with MBQ About How State Health Insurance Exchanges Impact Businesses

Cristie Upshaw Travis, CEO of Memphis Business Group on Health, talked with Richard Banks, blogger for the Memphis Business Quarterly's Business Minded Blog, about a critical component of healthcare reform, state health insurance exchanges, and how exchanges will impact Memphis businesses. Read the complete post to learn the basics about exchanges. Get information about how Tennessee is planning to implement exchanges by clicking "Health Insurance Exchange" tag at the end of this post... Read More
Posted by Cristie Travis at Tuesday, January 18, 2011

MBGH Helps MBQ Get a Handle on What Health Reform Means to Business

Cristie Upshaw Travis, CEO of Memphis Business Group on Health, helps Richard Banks, blogger for the Memphis Business Quarterly's Business Minded Blog, get, what he refers to as, a "semblance of comprehension" about what health reform means for business. In this first installment of a series of postings on the realities of health reform, Banks talked with Travis about decisions both large and small employers are making now that "sidestep" some of the early provisions of health reform, at... Read More
Posted by Cristie Travis at Thursday, January 13, 2011

Health Reform Impact on Dental & Vision Benefits Depends on Structure

Segal's December 2010 Health Reform Insights focuses on the impact of health reform on dental and vision benefits. Segal finds that self-insured dental and vision plans that are NOT separately elected and paid ARE subject to health reform. However, exemptions ARE granted for dental and vision plans that have a participant election and contribution. Interestingly, the 2010 Dental Benefits Enrollment Report , shows a decline in dental benefit enrollment for the first time since... Read More
Posted by Cristie Travis at Tuesday, January 4, 2011

MBGH's Health Reform Meeting Outlined Key Decisions for Employers

Andy Webber, CEO and President of the National Business Coalition on Health in Washington, DC, addressed a room full of Memphis employers and community leaders at Christian Brothers University on December 14,2010, on "Health Care Reform: The Uncertain Journey Forward" Andy suggested there are three chapters in health reform, each of which include key decisions for employers: Chapter 1: Health Insurance & Benefits Regulation Will employers choose to continue grandfather status for... Read More
Posted by Cristie Travis at Wednesday, December 15, 2010

Deficit Panel Targets Healthcare Cost Reduction to Reduce US Debt

Just when we were all beginning to adjust to the sweeping changes in health insurance plans required by Health Reform legislation passed in March 2010, we are now bombarded by the possibility of more changes included in the Deficit Panel's recommendations to reduce US debt. Although many of these specifics may not become law, most experts believe that they will, indeed, be considered and debated since healthcare costs and their rate of increase contribute significantly to the Federal deficit.... Read More
Posted by Cristie Travis at Thursday, December 2, 2010

Key Stakeholders Want TN to Operate It's Own Health Insurance Exchange

According to the State of Tennessee Insurance Exchange Planning Initiative, "Key stakeholders now express (in writing) their preference that Tennessee operate the exchange instead of the federal government.  These groups include all of the major insurers, both major associations for brokers and agents (i.e., Tennessee division of the National Association of Health Underwriters (NAHU) and National Association of Insurance and Financial Advisers (NAIFA) in Tennessee), Tennessee Medical... Read More
Posted by Cristie Travis at Wednesday, November 24, 2010

MBGH Hosts Successful Value-Based Insurance Design Webinar

MBGH hosted a successful Value-Based Insurance Design webinar on Thursday, November 4,2010 with A. Mark Fendrick, MD, co-Director of the Center for Value-Based Insurance Design at the University of Michigan. MBGH  has been working with Mark since February 2008, when MBGH launched our value-based benefits initiative to educate our members and Memphis-area employers on the principles of value-based benefits and to assist them in identifying opportunities to deploy those principles in... Read More
Posted by Cristie Travis at Thursday, November 4, 2010

Tennessee Starts to Evaluate Health Insurance Exchanges

Should the state of Tennessee establish its own health insurance exchange or tap into the national, federal exchange? That is the question being considered by the State of Tennessee under a $1 million grant from the federal government. I attended the "kick-off" meeting on October 22, 2010 for Tennessee's evaluation of the whole health insurance exchange issue. About 200 of us gathered in the central Nashville library to hear about the proposal TN had made for planning grant funds from the... Read More
Posted by Cristie Travis at Saturday, October 23, 2010

What is your premium increase for 2011?

Tell us what your premium (or premium equivalent if you are self-insured) increase is for 2011 .Approximately what is the amount of this increase that is due to changes required by health reform? Did you make some benefit design changes to reduce your premium increase? If so, what changes did you make and what do you think the impact of those changes were on your final premium increase?  Be sure to tell us if you are fully-insured or self-insured. Read More
Posted by Cristie Travis at Wednesday, October 13, 2010

New Over the Counter Rules Can Be Confusing

Effective January 1, 2011, employees must have a "prescription" to purchase over-the-counter medicines and drugs if they are to be categorized as "medical care" for purposes of the employer health plan and health savings accounts. Click here to read this concise summary from Alston & Bird and published in Employee Benefit News of the recently released IRS notice which provides clarifications around: What is a medication or drug? When is a medicine or drug considered prescribed?... Read More
Posted by Cristie Travis at Friday, October 1, 2010

Health Reform's Impact on Mini-Med Plans

Mini-med plans provide only the very basic health care coverage in order to keep premiums affordable and are usually offered to seasonal, part-time, temporary, blue-collar, and entry-level employees. Firms that offer mini-med plans include McDonald's, Waste Management, Dollar Tree, and TN's own, Gaylord Properties in Nashville. Health reform will significantly impact these plans in 2014 and it is possible that this option will disappear completely because mini-med plans do not generally... Read More
Posted by Cristie Travis at Thursday, September 16, 2010

Evidence Mounting: 2011 Will be a Messy Year for Both Employers & Employees

Survey results released over the past 2 weeks clearly indicate that employers of all sizes will be asking their employees to share in healthcare cost increases expected in 2011.For example: Large Employers: The National Business Group on Health 's survey of 72 large employers found employers expect an average trend increase of 8.9% in 2011. 63% will increase employee percentage contribution to premium cost, 46% will increase out-of-pocket max, and 44% will increase in-network... Read More
Posted by Cristie Travis at Tuesday, August 24, 2010

Memphis Employers: Accountable Care Organizations Are Coming! Are You Ready?

Memphis employers, employees & their families will definitely be affected by the latest trend to hit the healthcare delivery system: Accountable Care Organizations (ACOs). The concept is not entirely new but is a new version of an old idea: paying systems of care to be accountable for the health and health care of a group of people. So why all the buzz? Well, the recently passed Health Reform law requires Medicare to begin to work with these types of systems in 2012. Hospitals,... Read More
Posted by Cristie Travis at Thursday, August 19, 2010

Large Employers Rate Flexibility Over Advantages of "Grandfather" Status

A Hewitt Associates survey of 466 large employers released on August 10, 2010 indicates most expect to lose their Grandfather plan status in the next two years, and for sure by 2014. Reasons sited for loss include changes they plan to make regarding: Plan design (72%) Employee premium subsidy (39%) Insurance carriers (16%) Union contracts (15%) These employers indicate that overall health benefit strategy is more important than... Read More
Posted by Cristie Travis at Tuesday, August 17, 2010

Health Care Reform Costs to Insurers May Exceed Forecasts

Compliance with the new medical loss ratios by health plans could cost health insurance companies much more than originally predicted according to a recent study conducted by Weiss Ratings. Margins for health insurance companies already complying with medical loss ratio and other health reform requirements in 2009 had margins (on average) of only 0.7% while companies not yet complying had margins (on average) of 6.3%. Complying companies actually had negative margins from premiums with... Read More
Posted by Cristie Travis at Friday, August 13, 2010

New Health Plan Appeals Rules Announced by HHS

Click here to read the HHS fact sheet on the new internal/external appeals rules for NEW health plans. Grandfathered plans are not impacted by the new rules. The new rules provide health plan members with the ability to appeal denials to an outside, independent decision-maker. The National Association of State Insurance Commissioners is encouraging states to adopt these same appeals procedures. If states do not, members will have these same rights through the Federal regulations. NEW... Read More
Posted by Cristie Travis at Wednesday, July 28, 2010

Employers Face Penalties with New Non-Discrimination Rules

Click here  to read  the article from Employee Benefit News summarizing new non-discrimination rules re: executive medical plans. Read More
Posted by Cristie Travis at Tuesday, July 20, 2010

DOL FAQ on Mental Health Parity Offers Guidance for Grandfathered Plans

Click here to read Buck Consultants' summary of how recently released DOL FAQ ( click here to read) on mental health parity impacts grandfathered status under health reform. Read More
Posted by Cristie Travis at Wednesday, July 7, 2010

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