When should I have a check up and what screenings should I have?

Wednesday, June 29th, 2011 | Uncategorized | Comments Off

A well-person exam for adults ages 19 to 39* may include immunizations, counseling on health and wellness issues (topics may include nutrition-including discussion of folic acid supplementation for women of child bearing age; family planning; physical activity; injury prevention; misuse of drugs and alcohol; tobacco cessation; second hand smoke; sexual behavior; dental health; mental health) and screenings including: blood pressure; height, weight and body mass index (BMI); cholesterol every five years beginning at age 20.

For adults ages 40 to 64*, the well-person exam may include immunizations, counseling on health and wellness issues (topics may include nutrition; exercise; injury prevention; misuse of drugs and alcohol; tobacco cessation; second hand smoke; sexual behavior; dental health; mental health) and the following screenings:

• Blood pressure
• Height, weight and BMI
• Cholesterol: continued screening per doctor’s recommendation
• Colorectal cancer: beginning at age 50, screening recommendations include one of these six testing options:
  • Fecal Occult Blood Test (FOBT) each year
  • Flexible sigmoidoscopy every 5 years
  • Fecal Occult Blood Test (FOBT) each year, plus flexible sigmoidoscopy every 5 years
  • Double-contrast barium enema every 5 years
  • Colonoscopy every 10 years
  • CT colonography may be an appropriate alternative to colonoscopy

*These suggestions reflect recommendations for individuals of average risk. Individuals who are higher-risk, including but not limited to those in certain racial/ethnic groups or with personal/family medical history, should check with his/her health care provider for preventive health guidance.

W2 reporting and what employers need to know

Monday, June 27th, 2011 | Uncategorized | Comments Off

une 22, 2011

You’ve probably heard that employers will be required to report the cost of employer-sponsored health benefits on W-2 forms. Here are a few questions and answers about W-2 reporting and what employers need to know: 

1.     Why are employers required to do this reporting?

The recently enacted Affordable Care Act (or health care reform law) requires employers to include the cost of health coverage on the W-2 form in a new field starting with the 2012 tax year (W-2s filed in 2013). Employers who will issue fewer than 250 W-2 forms are exempt from this requirement until the 2013 tax year. 

2.     If the cost of health coverage is on the W-2, does this mean that it’s taxable?

No, this is a reporting requirement only and does not affect the amount taxed. 

3.     When do employers need to start issuing W-2s with this amount?

The requirement starts for the 2012 calendar year and reporting is optional for 2011. If an employer issues fewer than 250 W-2 forms, that employer does not have to start reporting until the 2013 tax year. 

4.     How do employers know what amount to report on W-2s?

There are three methods employers can use to calculate the cost of coverage:

1.     COBRA-applicable premium

2.     Modified COBRA premium

3.     Premium charged (for insured plans only) 

For more details on these methods, see the IRS Notice 2011-28 for interim guidance on how to calculate the cost of coverage. 

5.     What type of coverage doesn’t need to be reported on the W-2 form?

According to various sources, employers would not need to include these amounts in the W-2 reporting:

• Accident insurance
• Disability insurance
• Employee contributions to health care flexible spending accounts and health savings accounts
• Long-term care insurance
• Standalone dental and vision coverage
• Workers’ compensation insurance 

We expect to receive more guidance from the Internal Revenue Service, so this list may change.

Guide to Insurance for Small Business is Released by Division of Insurance

Wednesday, June 22nd, 2011 | Uncategorized | Comments Off

Thinking of starting your own business, and wondering what type of insurance you should have? Or has your business grown, and you want to know if your insurance coverage still matches the needs or your business?

The Colorado Division of Insurance has developed the “Guide to Insurance for Small Business” to provide an overview to many types of insurance so business consumers can make educated choices for insurance.

“Growth in small businesses is a critical element to Colorado’s economic health,” said John J. Postolowski, Interim Commissioner of Insurance. “The guide to insurance is one of many resources Colorado is providing to enable new and small businesses to succeed.”

While businesses count on insurance to protect the investment in time, money and other resources, consumers are also protected when businesses are insured. Should anything go wrong with goods and services, certain insurance may compensate people who interact with a business when there is a problem or concern.

The Guide to Insurance for Small Business can be found on the Division of Insurance website here:

For information on your business policy, contact us today.

No more health care waivers after Sept. 22, removing potential political distraction in 2012

Monday, June 20th, 2011 | Uncategorized | Comments Off

By Associated Press, Published: June 17

WASHINGTON — Removing a potential political distraction ahead of next year’s elections, the Obama administration Friday announced an early end to a health care waiver program that has come under fire from congressional Republicans.

Political considerations were “absolutely not” part of the decision, said Steve Larsen, head of a section of the Health and Human Services department that oversees President Barack Obama’s health care law.

Larsen said no new applications for waivers will be considered after Sept. 22. Approvals or renewals received by the deadline will be good through 2013. Starting in 2014, the main coverage provisions of the health care law will take effect, and such waivers will no longer be needed.

The waivers address a provision of the law that phases out annual dollar limits on coverage by health insurance plans. Starting this year, plans could not impose a limit below $750,000. But some plans, offered mainly to low-income workers, currently provide $50,000 a year in coverage, and in certain cases much less.

Those plans would have been forced to close down or jack up premiums significantly, leaving more people uninsured.

The waivers were established to avoid disrupting existing coverage. In 2014, taxpayer-subsidized insurance will be available to most of the people now covered by the affected plans.

Some Republicans charged favoritism in the granting of the waivers, alleging that they were being granted to unions. But a review this week by the Government Accountability Office found that HHS had approved over 95 percent of the 1,400 waiver applications it received, most of them involving employer plans. The nonpartisan investigative agency also found that the administration used objective standards to make its decisions.

Larsen said Friday that insurance experts have advised his office that most plans that needed waivers probably already applied for them this year. For that reason, the effects of ending the program early would be negligible.

A conservative policy expert who has been critical of the program wasn’t buying the technical explanation.

“It looks like they finally figured out they were in a public relations hole and decided to stop digging,” said Ed Haislmaier of the Heritage Foundation think tank.

Distracted Driving

Monday, June 13th, 2011 | Uncategorized | Comments Off

There are three main types of distraction:

• Visual — taking your eyes off the road
• Manual — taking your hands off the wheel
• Cognitive — taking your mind off what you’re doing

Distracted driving is any non-driving activity a person engages in that has the potential to distract him or her from the primary task of driving and increase the risk of crashing.

While all distractions can endanger drivers’ safety, texting is the most alarming because it involves all three types of distraction.

Other distracting activities include:

• Using a cell phone
• Eating and drinking
• Talking to passengers
• Grooming
• Reading, including maps
• Using a PDA or navigation system
• Watching a video
• Changing the radio station, CD, or Mp3 player.

Did You Know?

Research on distracted driving reveals some surprising facts:

• 20 percent of injury crashes in 2009 involved reports of distracted driving. (NHTSA).
• Of those killed in distracted-driving-related crashed, 995 involved reports of a cell phone as a distraction (18% of fatalities in distraction-related crashes). (NHTSA)
• In 2009, 5,474 people were killed in U.S. roadways and an estimated additional 448,000 were injured in motor vehicle crashes that were reported to have involved distracted driving. (FARS and GES)
• The age group with the greatest proportion of distracted drivers was the under-20 age group – 16 percent of all drivers younger than 20 involved in fatal crashes were reported to have been distracted while driving. (NHTSA)
• Drivers who use hand-held devices are four times as likely to get into crashes serious enough to injure themselves. (Source: Insurance Institute for Highway Safety)
• Using a cell phone use while driving, whether it’s hand-held or hands-free, delays a driver’s reactions as much as having a blood alcohol concentration at the legal limit of .08 percent. (Source: University of Utah)

Examination of Driver Distraction

Driver Distraction Facts and Figures

Important information regarding driver distraction comes from records of traffic fatalities and injuries collected by the National Highway Traffic Safety Administration.

Overview

Driver distraction could present a serious and potentially deadly danger. In 2009, 5,474 people were killed in U.S. roadways and an estimated additional 448,000 were injured in motor vehicle crashes that were reported to have involved distracted driving. Distracted driving comes in various forms, such as cell phone use, texting while driving, eating, drinking, talking with passengers, as well as using in-vehicle technologies and portable electronic devices.

There are other less obvious forms of distractions including daydreaming or dealing with strong emotions.

While these numbers are significant, they may not state the true size of the problem, since the identification of distraction and its role in a crash can be very difficult to determine using only police-reported data. New data sources are available to provide more details on the type and presence of driver distraction.

Highlights

Police-reported data from the Fatality Analysis Reporting System (FARS) and the National Automotive Sampling show that:

• In 2009, there were 30,797 fatal crashes in the United States, which involved 45,230 drivers. In those crashes 33,808 people died.
• In 2009, 5,474 people were killed in crashes involving driver distraction (16% of total fatalities).
• The proportion of fatalities reportedly associated with driver distraction increased from 10 percent in 2005 to 16 percent in 2009. During that time, fatal crashes with reported driver distraction also increased from 10 percent to 16 percent.
• The portion of drivers reportedly distracted at the time of the fatal crashes increased from 7 percent in 2005 to 11 percent in 2009.
• The under-20 age group had the highest proportion of distracted drivers involved in fatal crashes (16%). The age group with the next greatest proportion of distracted drivers was the 20- to-29-year-old age group – 13 percent of all 20-to-29-year-old drivers in fatal crashes were reported to have been distracted.
• Of those drivers reportedly distracted during a fatal crash, the 30-to-39-year-old drivers were the group with the greatest proportion distracted by cell phones. Cell phone distraction was reported for 24 percent of the 30-to-39-year-old distracted drivers in fatal crashes.
• Light-truck drivers and motorcyclists had the greatest percentage of total drivers reported as distracted at the time of the fatal crash (12% each). Bus drivers had the lowest percentage (6%) of total drivers involved in fatal crashes that were reported as distraction-related.
• An estimated 20 percent of 1,517,000 injury crashes were reported to have involved distracted driving in 2009.

The National Motor Vehicle Crash Causation Survey (NMVCCS) is a nationally representative survey specifically focused toward documenting events and conditions leading up to crashes.

• NMVCCS captures distraction as an associated factor to the crash and/or as the critical reason that made the crash imminent. Driver distraction was coded as the critical reason in 18 percent of the crashes. Data describing the specifics of the distraction — for example adjusting the radio or eating — are included in this data set.

Another method for collecting pre-crash data is through naturalistic driving studies, in which vehicles are equipped with cameras and data recording equipment.

• During NHTSA’s 100-Car Naturalistic Driving Study, driver involvement in secondary tasks contributed to more than 22 percent of all crashes and near-crashes recorded during the study period.

Data Sources

The following NHTSA data sources were used in the research:

• Fatality Analysis Reporting System (FARS)
• National Automotive Sampling System (NASS) General Estimates System (GES)
• National Motor Vehicle Crash Causation Survey (NMVCCS)
• The 100-Car Naturalistic Driving Study
• National Occupant Protection Use Survey (NOPUS) of Driver Electronic Use
• Motor Vehicle Occupant Safety Survey (MVOSS)

Use of Electronic Devices While Driving

A 2009 survey by the National Highway Traffic Safety Administration (NHTSA) reveals an increase in the use of electronic devices while driving and some regional differences in this practice.

Overview

The percentage of young drivers manipulating a hand-held electronic device while driving has decreased from 2008, according to the National Highway Traffic Safety Administration’s 2009 nationwide survey, which provides the only nationwide probability-based observed data on driver electronic device use in the United States. The survey shows that the hand-held cell phone use rate in 2009 translates into 672,000 vehicles being driven by someone using a hand-held cell phone at any given moment during daylight hours. It also translates into an estimated 9 percent of all vehicles that had drivers who were using some type of phone (hand-held or hands-free).

Highlights

• Nationwide, those drivers observed visibly manipulating hand-held electronic devices dropped significantly from 1.0 percent to 0.6 percent.
• Some 1.1 percent of drivers 16 to 24 years old were observed visibly manipulating hand-held electronic devices, down from 1.7 percent the previous year
• More drivers in Southern States were observed manipulating hand-held electronic devices (1.0%) than in the other regions of the country (from 0.2% in the Midwest to 0.5% in the West).
• The use of hand-held devices decreased the most in the West, from 2.1 percent in 2008 to 0.5 percent in 2009.
• The percentage of drivers visibly manipulating hand-held devices while driving was higher among females (0.7%) than among males (0.5%).

Methodology

The results above are from the National Occupant Protection Use Survey (NOPUS), which provides the only nationwide probability-based observed data on driver electronic device use in the United States. The NOPUS is conducted annually by the National Center for Statistics and Analysis (NCSA) of the National Highway Traffic Safety Administration. The survey observes usage as it actually occurs at randomly selected roadway sites. The survey data is collected by trained observers at probabilistically sampled intersections controlled by stop signs or stoplights, where vehicle occupants are observed from the roadside. Data is collected between 7 a.m. and 6 p.m.

Only stopped vehicles are observed to allow time to collect a variety of information required by the survey, including subjective assessments of occupants’ age and race. Observers collect data on the driver, right-front passenger, and up to two passengers in the second row of seats. Observers do not interview occupants, so that the NOPUS can capture the untainted behavior of occupants. The 2009 NOPUS data was collected between June 1 and June 22, 2009, while the 2008 data was collected between June 2 and June 22, 2008.

US Judges Raise Pointed Questions About Health Law

Thursday, June 9th, 2011 | Uncategorized | Comments Off

Associated Press
June 09, 2011

Three federal appeals judges expressed unease with a requirement that virtually all Americans carry health insurance or face penalties, as they repeatedly raised questions about President Barack Obama’s health care overhaul.

At a Wednesday hearing, the three judges on the 11th Circuit Court of Appeals panel in Atlanta questioned whether upholding the landmark law could open the door to Congress adopting other sweeping economic mandates. The judges did not immediately rule on the lawsuit brought by 26 states, a coalition of small businesses and private individuals who urged the three to side with a federal judge in Florida who struck down the law.

But the pointed questions about the so-called individual mandate during almost three hours of oral arguments suggest the panel is considering whether to rule against at least part of the federal law to expand health coverage to tens of millions of Americans. Federal appeals courts in Cincinnati and Richmond have heard similar legal constitutional challenges to the law within the last month, and lawyers on both sides agree the case is headed for the U.S. Supreme Court.

At issue Wednesday was a ruling by U.S. District Judge Roger Vinson of Florida to invalidate the entire law, from the Medicare expansion to a change that allows adult children up to age 26 to remain on their parents’ insurance. The government contends that the law falls within its powers to regulate interstate commerce. Chief Judge Joel Dubina, who was tapped by Republican President George H.W. Bush, struck early by asking the government’s attorney “if we uphold the individual mandate in this case, are there any limits on Congressional power?” Circuit Judges Frank Hull and Stanley Marcus, who were tapped by Democratic President Bill Clinton, echoed his concerns later in the hearing.

Acting U.S. Solicitor Neal Katyal sought to ease their concerns by saying the legislative branch can only exercise its powers to regulate commerce if it will have a substantial effect on the economy and solve a national, not local, problem. Health care coverage, he said, is unique because of the billions of dollars shifted in the economy when Americans without coverage seek medical care. “That’s what stops the slippery slope,” he said.

Paul Clement, a former U.S. solicitor representing the states, countered that the federal government should not have the power to compel residents to engage in commercial transactions. “This is the case that crosses the line,” he said. Hull also seemed skeptical about the government’s claim that the mandate was crucial to covering most of the 50 million or so uninsured Americans. She said the rolls of the uninsured could be pared significantly through other parts of the package, including expanded Medicare discounts for some seniors and a change that makes it easier for those with pre-existing medical conditions to get coverage. Dubina nodded as she spoke.

The appeals court panel, which did not indicate when it would rule, has several options. But Hull and Dubina asked the lawyers on both sides to focus on a particular outcome: What could happen to the overhaul, they asked separately, if the individual mandate were invalidated but the rest of the package were upheld? Parts of the overall law should still survive, said government lawyer Katyal, but he warned the judges they’d make a “deep, deep mistake” if the insurance requirement were found to be unconstitutional. He said Congress had the right to regulate what uninsured Americans must buy because they shift $43 billion each year in medical costs to other taxpayers. Clement, however, argued that the insurance requirement is the “driving force” of the broader package, which he said violates the Constitution’s legitimate authority. Without it, he said, the rest of the package should collapse. “If you take out the hub, the spokes will fall,” Clement said.

Marcus, meanwhile, said the case struck him as an argument over individual liberties, but questioned whether the judicial branch should “stop at the water’s edge” or intervene. So far, three Democratic-appointed federal judges have upheld the health care law and two Republican-appointed judges, including Vinson, have ruled against it. Wednesday’s arguments unfolded in what’s considered one of the nation’s most conservative appeals courts. But the randomly selected panel represents different judicial perspectives. None of the three are considered either stalwart conservatives or unfailing liberals.

Dubina, who came to the bench as a federal magistrate in 1983, is not considered to be as reflexively conservative as some of his colleagues. But he’s under particular scrutiny because of his daughter’s outspoken opposition to the health care overhaul. U.S. Rep. Martha Dubina Roby, a Montgomery, Ala., Republican elected in November, voted to repeal the health care ban because she said it was “less about providing health care for all citizens, and more about expanding federal government.” Marcus was nominated by Republican President Ronald Reagan to serve on the Florida bench after several years as Miami’s lead federal prosecutor; he was later elevated by Clinton. And Hull, a former county judge in Atlanta, is known for subjecting both sides of the counsel table to challenging questions.

A crush of people gathered outside the 11th Circuit nearly three hours before the arguments were held to guarantee a spot, and the court opened an adjoining courtroom for the spillover crowd. The cramped room was packed with high-profile attorneys and politicians, including Georgia Attorney General Sam Olens, who sat in the front row. In a rare move, the court decided to sell $26 audiotapes of the arguments for those who missed out. As the arguments took place, about 75 people staged a rally outside the downtown Atlanta building urging the appeals court to strike the law down, waving signs including one that read “Hands Off My Health Care.”

What’s happening in Washington

Friday, June 3rd, 2011 | Uncategorized | Comments Off

The big story in Washington right now is Medicare. There’s widespread agreement that the current system is unsustainable. But there’s no agreement over what to do about it – or even how to address the issue in the current hyper-competitive political environment.

As Rep. Paul Ryan, R-Wis., said last month, “Every time you put entitlement reform out there, the other party uses it as a political weapon.” The weapon is pointed at Ryan and the Republicans right now. Ryan’s proposal for Medicare reform was part of the reason the GOP lost the special election in upstate New York last week to fill a vacant House seat.

But Republicans attacked the Democrats in the same way last fall. In fact, one reason the GOP was able to take back the House was that Republican candidates beat up Democrats for cutting Medicare during health reform.

And yet, as former President Bill Clinton told Democrats in the wake of their New York state victory last week, the country can’t afford to use the entitlements and Medicare issues solely for political gain: “We’ve got to deal with these things,” he said.

Consider a few numbers:

• According to the Centers for Medicare and Medicaid Services (CMS), Medicare had 19 million enrollees – or 9 percent of the population – when the program began in 1965. This year it has 45 million – or 16 percent of the population – and the number is growing.
• People are living longer – the average life expectancy now is 78; it was 71 in 1965.
• The Medicare Trustees Report says that Medicare spending was $7.5 billion in 1965 (3.5 percent of all spending in 1970). Now it’s $523 billion (15 percent of spending, according to the Office of Management and Budget).

Still, New York Senator Chuck Schumer, who is vice chairman of the Democratic caucus, has promised that Medicare will be a “defining issue” in 2012. Rep. Steve Israel, chairman of the Democratic Congressional Campaign Committee, said, “This is only the first seat….We took that fight to one of the most conservative congressional districts in America. We won. So we will continue the strategy.”

Two days after the Democratic victory in New York, Majority Leader Harry Reid, D-Nev., implemented the strategy in the Senate by calling for a vote on the Republican House budget proposal, which included the Ryan plan to change Medicare. Every Democrat voted against it; all but five Republicans voted for it. Schumer said, “We will exhibit this issue as an example of why we need to keep the Senate Democratic in order to counter House Republicans. We will point to this week and say the Republicans tried to end Medicare, but a Democratic majority stopped it in the Senate. It’s that simple.”

Meanwhile, Republican senators were given talking points cards to help them defend their “yes” votes. Among the messages were:

• “Medicare part A: Insolvent by 2014″
• “Less money coming in this year than being paid out”
• “Obamacare cut half a trillion from Medicare to spend on new programs”
• “Republicans want to save Medicare while Democrats say do nothing”

Also last week, the House Energy and Commerce Subcommittee on Health held a hearing on selling health insurance across state lines. Chairman Joseph Pitts, R-Penn., pointed out that states have enacted more than 2,100 mandates across the nation, which increases the cost of coverage and prices people out of the market. Rep. Frank Pallone, D. N.J., said that interstate sales would allow insurers to “operate under the laws of states with weaker consumer protection and risk-pooling standards” and would “quickly result in a race to the bottom.”

This week, the House is at work in Washington, while senators are at work in their home states. The House Energy and Commerce Subcommittee on Health will hold a hearing on the “Health Care Law’s Regulatory Burden.”

The industry group America’s Health Insurance Plans will testify, focusing on the burdens and unintended consequences that will result from the MLR (medical loss ratio) requirements. They include the disruption of health care choices for consumers, stifling health plan innovation, reducing access to brokers and agents, and turning back the clock on quality improvement initiatives.