Sunday, June 30, 2013

A look at Access Health CT's role in federal health reform

Access Health CT is working, under federal health reform regulations toward becoming a new option to select and enroll in a medical insurance plan. Open Enrollment for Individuals and Small Employers in Conn begins October 1st for coverage effective January 1, 2014. Some information:

● The media campaign to increase awareness of this new option is now underway.

● Residents, as part of the enrollment process on the Individual part of Access Health CT site, may qualify for premium support. This support is based on income and is technically a tax credit. Information on the income range can be seen here.

● The page on the above link includes a calculator. By entering income information it will show what your share of the monthly premium will be.

This pdf summary highlights 10 points about the Access Health CT program.

● Small businesses will be able to go to the Small Business Health Options Program or “SHOP” part of Access Health CT. Some information can be seen here.

● Certain small employers may be eligible for a tax credit to offset part of the expense of their medical benefit plan. In 2013 any small employer can apply for a tax credit of up to a 35%. This changes to 50% in 2014 and is only available if the firm selects a plan through the SHOP part of Access Health CT.
Note: The maximum credit is only be available if an employer has 10 or fewer employees, excluding the owner, and the average salary for these employees is $25,000 or less. The credit drops quickly and is not available to firms with 25 or more employees or if the employee average salary is $50,000 or higher.

Contact me - (860) 451-9793 - if questions about Access Health CT or the medical plans for Individuals or Small Employers, which are anticipated to be available.

John C Parker, RHU, LTCP
Niantic CT

Monday, June 17, 2013

Goings on with medical treatment and what these costs mean to medical benefit costs.

The healthcare industry, both on the delivery and financing side, is way behind others such as banking in the use of technology. Many have made statements like this over recent years so let’s take a look at what is going on today.

The June 2013 issue of the HealthLeaders magazine includes an article “Seeking the Strategic Sweet Spot” and brings out some steps providers are now or need to take to reform the way they operate. I want to share some points from the article on what this means for the way primary care will be provided:

● A team of people with varied talents working toward the same goal – management of populations

● Physicians working with high risk patients and funneling low-risk, low-acuty patients to physician assistants and nurse practitioners.

● A big move to telemedicine among younger patients.

● “About 80% of the office visits done right now by primary care can be done by midlevel providers and 80% of what the midlevels do can be done over the telephone”.

I found this last one of considerable interest. It represents one of the important steps for employers – to help employees understand the best way to deal with medical related situations.

Another factor, which is affecting providers, is the continuing trend of more and more consolidation among physicians and hospitals. A point was made on why this is happening:

● In narrow operating margin industries, which healthcare is destined to become, because of cost pressures “you need economies of scale and scope”.

We also find across the U.S. and here in Connecticut medical treatment costs, which some say are increasing at more than twice the rate of normal inflation. One part of this, which is having a very big impact, is the use of expensive medications.

What does all this mean for employee medical benefits? Increasing treatment costs result in higher plan premiums, which has a direct impact on an employer’s business and on the amount employees are asked to contribute as their share of plan costs. In addition, to increasing treatment costs medical benefit plan costs will face higher costs as federal health reform is implemented in the coming months.

Some steps employers are using to offset the ever increasing cost of the medical benefit plan:

● Working to help employees understand how lifestyle choices result in higher costs for them and the firm. They are also providing incentives for employees to work for better health.

● Encouraging, through employee contributions, the selection of cost effective health plans.

● Introducing a defined contribution approach as a step to control future costs.

Please contact if any questions on what these issues mean to individuals and employers here in Connecticut.

John C Parker, RHU, LTCP – (860) 451-9793

Thursday, June 06, 2013

Employers in Conn required to provide, by Oct. 1, all employees a letter on federal health reform

Federal health reform includes a requirement for all employers to notify their full and part time employees about the coming availability of the Health Insurance Marketplace. Here in Conn our Marketplace is known as Access Health CT. Information is available here.

Model letters on what is to be included in the letters was issued by the federal Department of Labor in early May. One letter is for employees who currently have medical insurance from their employer. The second is for employees who do not have employer provided medical insurance.

Note: Even though model letters were issued some of my professional association contacts in Washington DC indicate the letters may be changed. Then too, it is normally more effective to communicate to employees close to the time they can do something so it may be best to wait.

Call today if any questions on the federal requirement to notify employees about health reform. (860) 451-9793

In regard of Access Health CT. Four health insurance companies have submitted an application to become a Qualified Health Plan and offer medical insurance plans to individuals here in Conn. Aetna, Anthem BC & BS of CT, ConnectiCare, and HealthyCT. HealthyCT is a new type of health insurance company created by federal health reform, which is called a Consumer Operated and Oriented Plan (CO-OP). Here is some info on the Conn CO-OP. started by the Connecticut State Medical Society.