AngioScreen – Know more than your cholesterol level!
Forty percent of all Americans having a stroke have normal cholesterol levels. Not what one would expect considering vascular disease is the leading cause of death worldwide and the leading cause of heart attack and stroke. A six minute health screen will provide the information needed. AngioScreen is a simple, non-invasive vascular screening designed to […]
Memorial Day – Short History Lesson
Memorial Day was formerly known as Decoration Day and originated after the American Civil War to commemorate the Union and Confederate soldiers who died in the war. By the 20th century, Memorial Day had been extended to honor all Americans who have died while in the military service. (Memorial Day is not to be confused […]
Rx Impact – Bid Rx – Prescriptions for Less (Part 2 of 2)
BidRx (www.bidrx.com) is a website built by pharmacists that links consumers with pharmacies and pharmaceutical companies, so consumers can make better decisions when purchasing prescription drugs. BidRx provides the information needed to identify the best value drug; then pharmacies compete for filling prescriptions. Consumers can See cost of prescriptions (original plus alternatives) and services. See list of […]
Rx Impact – Specialty Drugs (Part 1 of 2)
Specialty Drugs – generally referring to drugs costing over $600 per month – are estimated to account for 30% of total drug costs and expected to reach 50% by 2018. These drugs are expensive to develop and pose challenges manufacturing. However they target life altering illnesses making them an absolute must if needed. These patients […]
New Rule on Market Reforms – 22% MLR
The rule makes a temporary change to the administrative cost ceiling. Currently, as a result of the Medical Loss Ratio (MLR), insurers are allowed to have 20% of their costs be administrative, with the other 80% devoted to claims. That number has been increased to 22% for 2015 under the proposal to accommodate the increased […]
ACA Recap – Employer Checklist (Part 5 of 5): Exchanges
Types of Exchanges 1. State Exchanges – Individual Consumer – Federal or State Run Carrier participation will be voluntary State determines plan designs: Bronze (low cost), Silver, Gold, Platinum (high cost); Catastrophic Plan – young invincibles (18 -30) 2. SHOP Exchange – Small Employers Open in 2015 Limited to 50 FTE’s Employer picks plan for […]
ACA Recap – Employer Checklist (Part 4 of 5): Underwriting
Under ACA beginning with all new groups and for groups renewing in the 2014 calendar year the following criteria will be used to underwrite group. (In Florida, group size is determined by ATNE, Average Total Number of Employees. ATNE is calculated by averaging the total number all employees, full & part time, seasonal, temporary, etc… for […]
ACA Recap – Employer Checklist (Part 3 of 5): Compliant Plans
What is a Minimum Value Plan? Coverage that has an actuarial value (AV) of at least 60%. AV is the plan’s share of the total allowed cost of benefits provided to an enrolled individual Example, if a plan has an AV of 60% then the individual is theoretically responsible for 40% of the costs for all […]
ACA Recap – Employer Checklist (Part 2 of 5): Affordability
ACA Employer Responsibility Affordable Coverage Requirement Companies are only required to offer at least one medical plan that meets the “affordability” requirement (at the employee-only coverage level). Regulatory guidance allows companies to calculate affordability based on the employee’s income, using one of three IRS safe harbors. The Safe Harbors are: 9.5% of W-2 wages from […]
ACA Recap – Employer Checklist (Part 1 of 5): Accessibility
ACA Employer Responsibility: “Pay or Play” (Delay Announced) Large Employer Subject to “Pay” if they do not “Play” – Starting in 2015, applies to employers with 100 or more FTEs (Full Time Equivalents) Offer Minimum Essential Health Care to 70% of employees effective on the start of the plan year beginning on or after January […]