Health Insurance - The Roller Coaster Ride Continues...

Here is a brief overview of what has happened.  If you know this or don’t want to read it all, make sure you read the last part. 

 

Maryland Health Care and Insurance Reform Act of 1993

• Guarantee small business access to health insurance
• Reduced premiums by about 30%
• Set consumer protection
• Eliminated medical underwriting & pre-existing condition exclusions
• Required insurance companies to offer similar plans
• Required premiums to be determined by age and geography

 

Does this sound anything like the goals of the Affordable Care Act (ACA)?

 

Why rates were going up before the ACA

• Health care benefits increased 72% since 2000
• Population is aging
• Rise in obesity and chronic illnesses
• Introduction of new treatments
• More diagnostic testing
• Defensive medicine
• Higher premium tax costs of regulatory medicine

What were the major changes with the ACA?

• Preventive services are free
• Individuals are required to have insurance or pay a fine
• An exchange must be created
• Individual subsidies based on income
• Employers with 50+ employees must offer health insurance
• Expansion of Medicaid

 

Ok, so we dealt with this.  Now what?  Most group renewals in the last half of 2015 had increases of no more than 5%.  Individual coverage for January 2015 had modest increases (maybe 15%).  Look out for 2016!  We have heard that individual increases are 10% - 55%!  What about group plans?  The rates are being promoted as lower.  In many cases, that will be true.  Pay attention or you may be shocked!  Here is an actual case for a January 1, 2016 renewal. 

 

 

 

HMO Plan $1,500 Deductible

 

                                     January 1, 2015          January 1, 2016

 

Copays                                    $30/$30                         $25/$50

Hospital Inpatient Charge       $250 per admission       $500 per DAY

Out of Pocket Maximum         $4,000/$8,000               $6,550/$13,100

Emergency Room                    $100                              $250

 

Using a simple example of someone taken to the Emergency room and then being admitted to the hospital for 10 days would look something like this. 

 

Hospital Inpatient Charge 

2015:         $250

2016:         $5,000             

 

Hopefully, it won’t impact too many people.  But if it is you or an employee, it will leave a lasting impression.  

 

 

CareFirst - Cyber Attack

CareFirst – Cyber attack 

 

CareFirst has confirmed that they have been the subject of a cyber attack.  The information that was compromised was limited (not social security numbers, medical info, etc.).  People may be more vulnerable to phishing attempts which may be more plausible. 

 

CareFirst is offering two years of free credit monitoring and identity theft protection services for those members affected. If people have been affected, they will receive letters from CareFirst.  There is additional information in the link below.

 

http://www.carefirstanswers.com/home.html

Ridesharing – Have you heard of it?

Ridesharing – Have you heard of it?

 

If not, have you heard of Uber or Lyft?  Quite simply, the mobile-phone application facilitates peer-to-peer ridesharing by connecting passengers who need a ride to drivers who have a car.  It has become one of the biggest threats to the traditional taxi and sedan services that have additional requirements. 

What will happen if an individual is involved in an accident and does not have automobile insurance designed for transporting passengers for a fee?  Will there be coverage for anyone? 

Think about the implications if you are considering being a driver or a passenger?  See the below flyer for more information. 

Health Insurance – Who needs it?

Everybody – with few exceptions. 

The Affordable Care Act (ACA) included an individual mandate stipulating that effective January 1, 2014, people must have insurance meeting minimum essential coverage or pay a penalty at tax time.  Consumers can enroll for coverage through a special enrollment period that will run from March 15 through April 30 if they attest that they became aware of the penalty during this income tax filing season.

This is the first time that consumers will be asked to provide basic information

regarding health coverage on their federal tax returns. Because this requirement is new, some Marylanders are unaware of the requirement and the fee. 

 Please see the full press release at the following link.  http://marylandhbe.com/wp-content/uploads/2015/02/02252015-SpecialTaxEnrollment.pdf

 I have been certified to assist with enrollment through Maryland Health Connection (Exchange) if you would like help. 

 

Robert Cannon

Vice President

410-561-8280

 

Protecting Against Cybercrime

What is Cybercrime?

Cybercrime is any violation of federal, state, or local statute, or malicious or suspicious activity, in which a computer, network or device is an integral component of the violation. Examples can include: a malicious cyber criminal breaking into a computer to steal information (computer intrusion) or to change a website (website defacement); malware being placed on a computer without the owner’s permission; and that malware using that computer’s resources to send spam.

 Who Are the Actors and What Do They Want?

Cybercrime actors can generally be classified into several categories: lone hackers, script kiddies, insiders, hacktivists, terrorists, nation-states, and organized cyber criminal groups.  The motivations for committing cybercrime will vary and can include a desire for recognition or promotion of an ideology; theft of money or information for industrial espionage; or the creation of widespread disruption.  Cybercrime is big business.  Between October 1, 2013, and December 31, 2014, for example, U.S. victims lost nearly $180 million through a scam known as the Business Email Compromise.  One underground market has more than 14 million U.S. credit cards for sale.  The creators of the CryptoLocker ransomware earned approximately $300,000 profit in its first 100 days.

 How Can You Protect Yourself?

Cybercrime—whether from malware on a single computer or the recent high-profile hacks against Sony, Target, Home Depot and others—impacts everyone. Below are some key practices you can use to help minimize your risk of being a victim:

 

·         Configure Your Computer Securely

Make sure your computer, smartphones, and tablets are safe.  Use privacy and security settings in your software, email system and web browsers. New strains of malicious software are appearing all the time, so it is imperative to regularly update your anti-virus software to identify and thwart the newest threats.

 

·         Keep Software and Operating Systems Updated

Be sure to install all software updates as soon as they are offered; using the “auto update” setting is the best way to ensure timely updates.  Similarly, make sure you keep your operating system and any third-party plug-ins that you use updated.

 

·         Use Strong Passwords

Never use simple or easy-to-guess passwords like “123456” or “p@$$word” or “football.” Cybercriminals use automated programs that will try every word in the dictionary in a few minutes.  When creating a password, use at least 10 characters, with a combination of uppercase and lowercase letters, numbers, and symbols.

 

·         Be Cautious About Links and Attachments

Be cautious about all communications you receive including those purported to be from friends and family, and be careful when clicking on links in those messages. When in doubt, delete it.

 

·         Protect Your Personal Information

Be aware of financial and sensitive information you give out. Cybercriminals will look at your social networking webpage to find information about you--remember, many of the answers to website and bank security questions can be found online, like the color of your car (remember posting that picture of you standing in front of your car?) and your mother’s maiden name.  Use privacy settings to limit who can see the details of your social network pages, and be smart about what you decide to share online.

 

·         Review Your Financial Statements Regularly

Cybercriminals find loopholes and your accounts may get hacked through no fault of your own, so review your financial statements regularly. Contact your financial institution immediately if you see any suspicious looking activity.

 

What to Do If You Are a Victim?

·         If you’ve been a victim of identity theft,  notify your bank, and any other entities with which you have accounts, to inform them that someone may be using your account fraudulently. Contact all three major credit bureaus to request a credit report, and have a fraud alert and a credit freeze placed on your account.

 

·         Internet-related crime, like any other crime, should be reported to appropriate authorities at the local, state, or federal levels, depending on the scope of the crime.

 

 

Provided by:

 Center of Internet Security

Are your vehicles prepared for the winter roads?

Reliable transportation is especially important in the winter. Driver and vehicle preparation needs to be taken seriously because maneuvering in the snow and ice requires special skills. To prevent a winter wonderland from becoming a winter nightmare, below are some helpful tips.

The good news is there are steps you can take to help prevent vehicle problems from occurring when the temperature drops:

• Take the vehicle to a mechanic to check out the battery, antifreeze level, thermostat, heater, brakes and defroster.
• Check to make sure the tires have adequate tread for better traction, and that they are equipped to handle extreme winter driving.
• Make sure the front and rear lights are operational, especially the car's flashing hazard lights.
• Top off the washer fluid reservoir. Make sure to only use washer fluid, as it doesn't freeze and will help break down the frozen layer on the windshield.
• Stock the vehicle with basic winter driving equipment, such as a scraper and brush, small shovel, jumper cables and a bag of sand or cat litter for tire traction.
• Fill the gasoline tank, even for a short distance, and stop to fill-up long before the tank begins to run low. Keeping the tank as full as possible will minimize condensation that can lead to freezing and provide the maximum advantage in case of trouble.
• Always store a first aid kit. This should include all the usual items plus winter extras like flashlights, a fresh supply of batteries, blankets, matches, extra clothing, bottled water and non-perishable snacks.

Patient-Centered Outcomes Research Institute Fee (PCORI)

New fee will fund research and consumer-based health decisions

Established by The Patient Protection and Affordable Care Act (PPACA), the Patient-Centered Outcomes Research Institute (PCORI) is charged with examining the “relative health outcomes, clinical effectiveness, and appropriateness” of different medical treatments. The Institute will evaluate existing studies and conduct its own, with funding in part by employer-paid fees.

Initial mandates include a new fee imposed on employers and insurance carriers for seven years, with fee amounts expected to change during that time. Due each July 31st, this fee is now set to affect Clients with Plan years ending 2012 through 2019.  If a plan sponsor only maintains a flexible spending account (FSA) or a health reimbursement arrangement (HRA), then the plan sponsor may treat each participant's account as covering a single life. (The plan sponsor is not required to count spouses or other dependents.)

 

Calculating the Fee

The fee is equal to the average number of covered lives for the policy year times the applicable dollar amount.

• For policy years ending on or after Oct. 1, 2012, and before Oct. 1, 2013 - the applicable dollar amount is $1.
• For policy years ending on or after Oct. 1, 2013, and before Oct. 1, 2014 - the applicable dollar amount is $2.

Self-funded plans may determine the average number of covered lives by using any of the following methods. Like fully insured plans, plan sponsors must use the same method consistently for the duration of any year and the same method for all policies subject to the fee.

• Actual Count – Count the total covered lives for each day of the plan year and divide by the number of days in the plan year.
• Snapshot dates – Count the total number of covered lives on a single day in a quarter (or more than one day) and divide the total by the number of dates on which a count was made. (The date or dates must be consistent for each quarter.)
• Snapshot Factor – In the case of self-only coverage, determine the sum of: (1) the number of participants with self-only coverage, and (2) the number of participants with other than self-only coverage multiplied by 2.35.
• Form 5500 Method – For self-only coverage, determine the average number of participants by combining the total number of participants at the beginning of the plan year with the total number of participants at the end of the plan year as reported on the Form 5500 and divide by 2. In the case of plans with self-only and other coverage, the average number of total lives is the sum of total participants covered at the beginning and the end of the plan year, as reported on the Form 5500.

Are health insurance policies or self-insured health plans for tax-exempt organizations or governmental entities subject to the PCORI fee?

Yes. Unless the health insurance policy or self-insured health plan is an exempt governmental program described above, the policy or plan is a specified health insurance policy or applicable self-insured health plan subject to the PCORI fee and, accordingly, the health insurance issuer or plan sponsor is responsible for the PCORI fee.

 

The employer is responsible for paying the PCORI fee and filing the Form 720 with the Internal Revenue Service (IRS).  This is because the HRA is funded by the employer.

 

You can access additional information on IRS Questions & Answers.