Boca Benefits Consulting Group Inc.

Following on CIGNA’s earlier announcement this week regarding early implementation of the PPACA “to age 26” provision, CIGNA has announced today that they will also implement early the “anti-rescission” provisions of PPACA prior to the statutory requirement of 9/23/2010. CIGNA has announced they will make the policy change effective 5/1/2010.

It would appear that CIGNA is attempting to capture the public relations high ground on these decisions relative to their healthcare insurance competitors. However, these are relatively easy changes to effect and will not substantially alter the competitive balance as other major carriers make similar decisions to implement certain PPACA provisions early.

Below Excerpt from CIGNA Press Release:

<<<

CIGNA’s business practices are already compliant with the suggested reforms that are to be implemented on September 23, 2010. CIGNA is confirming that it will not rescind the coverage of any premium-paying customer except in cases of deliberate fraud or intentional misrepresentations of material facts. CIGNA will also institute a policy of third party review if a rescission is to be made.

>>>

Click here for full press release.


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BBCG is represented on the board of NAIFA-Pinellas (National Association of Insurance and Financial Advisors, Pinellas County, Florida). The below bullet points are insurance/benefits related items addressed in the Week #8 dispatch from the 2010 regular Florida Legislative Session.  Please see below link to access the dispatch.

• LEGISLATURE SENDS NAIFA-FLORIDA PRIORITY BILL TO THE GOVERNOR (HB 159)
• LEGISLATURE APPROVES LIFE INSURANCE BILL WITH NAIFA-FLORIDA SUITABILITY CE EXEMPTION PROPOSAL (HB885)
• NOVEMBER BALLOT WILL CONTAIN CONSTITUTIONAL AMENDMENT TO EXEMPT FLORIDA  FROM FEDERAL HEALTH REFORM MANDATE (HB 37)
• 2010 SESSION WILL ADJOURN WITHOUT SIGNIFICANT HEALTHCARE REFORMS
• PROPERTY BILL CLEARS SENATE FLOOR; CONSUMER CHOICE STALLED (SB 2044/HB 447)
• NUMEROUS COSTLY MANDATE BILLS FILED

Go to NAIFA archive page for full details.

BBCG is represented on the board of NAIFA-Pinellas (National Association of Insurance and Financial Advisors, Pinellas County, Florida). The below bullet points are insurance/benefits related items addressed in the Week #7 dispatch from the 2010 regular Florida Legislative Session.  Please see below link to access the dispatch.

• NAIFA TO TESTIFY BEFORE COMMISSIONER MCCARTY AGAINST FEDERAL MEDICAL LOSS RATIOS
• NAIFA-FLORIDA PRIORITY LEGISLATION CLEARS FINAL COMMITTEES – HEADED TO THE FLOOR
• LIFE INSURANCE BILL STRIPPED OF CONTROVERSIAL FEDERAL HEALTH REFORM PROVISIONS
• AUTISM & MENTAL HEALTH PARITY MANDATES STILL PUSHING FORWARD
• HOUSE AND SENATE MOVE CLOSER TO AGREEMENT ON PROPERTY BILLS
• CFO SINK’S PRIORITY ANNUITY LEGISLATION GAINS APPROVAL OF THE SENATE
• NUMEROUS COSTLY MANDATE BILLS FILED

Go to NAIFA archive page for full details.

We are not the only systems being hacked. New U.S. Cyber Command gears up for probes. It is not all paranoia.

See this link regarding information provided at Senate Armed Services Committee confirmation hearing.

BBCG’s blog is back up at 12:00 noon 4/15/2010. We are trying a different look on this blog concurrent with the conversion to the most recent version of WordPress. It is cleaner and easier for a new user to navigate. We also feel it is just a lot easier to read due to its font and layout. Let us know how you like it!

BBCG downloaded all files related to this blog today and scanned them for malicious scripts utililzing McAfeee definitions. No WordPress files associated with this blog were found to be infected.  See http://1msc.com/blog/?p=235 for related information.

Our WordPerfect version conversion was delayed today as we scanned the present blog files and related database. Planned conversion completion is 4/15/2010.

Please see http://1msc.com/blog/?p=189 and http://1msc.com/blog/?p=192 for information on recent hacker activity realive to older WordPress versions. BBCG has noted substantial illigitimate user activity in the last 90 days and today discovered a trojan script embedded in one of the 1msc.com blog files.

This blog will be down for a few hours on 4/14/2010 as BBCG converts it to the most recent version of WordPress. Please note that no malicious script activity has been noted on the bocabenefits.com blog site. We are taking this measure as a precaution only.

Many cost strapped employers are looking for ways to have older, more costly, employees seek early retirement without violating any age discrimination statutes. Below are some healthcare considerations to think about if you are approached.

If retiring at approximately 62 years old, there are four  healthcare options that might be available to you:

• COBRA ( http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML )
• Individual policy ( http://bocabenefits.com/GR 4-2009 Plans Brochure.pdf   )
• A “bridge” provided by the employer to age 65
• New employer with a group plan

COBRA with ARRA 2009 Considerations

In the case of COBRA, the expense may or may not be prohibitive depending on how your separation from service is actually defined. If “involuntary” between now and 12/31/2009 the 65% subsidy required by the American Recovery & Reinvestment Act 2009 would apply and for the nine months following the separation date your cost would be 35% of the normal 102% of true cost COBRA rates (i.e., true cost being what the total premium is for your enrollment type, not just the percentage of the cost passed along to the employee) for that period. Unless the ARRA 2009 were to be extended, the costs would go back to 102% of true costs at that point. See the piece at http://bocabenefits.com/stimulus_cobra.pdf for more info. Specifically, take a look at the income thresholds that might reduce the subsidy for you. Note: this is a zero cost subsidy for your employer.  One hundred percent of the subsidy amount is recovered via a payroll tax offset.

Individual Health Policies

Individually purchased policies are problematic for several reasons. Costs for just one person at 62 will run about $400-$500 per month (possibly less if an HSA plan). Essentially twice that for a couple. They are also not “guaranteed issue” meaning that your health status will be considered before an application is accepted and a policy issued. You can be declined, be up-rated or have policy benefit terms modified.

Early Retirement Bridge With Current Employer

A “bridge to 65” agreement with an employer is usually the best course for everyone. That is, the employer continues the employee on the health plan as if they remained an active employee until they reach Medicare eligible age. It is likely that the employee would be kept in prolonged “leave of absence” status to remain qualified for participation in the plan if no retirement health is offered otherwise. A highly paid, tenured employee can be replaced by a less experienced and less expensive new hire. Over the course of three years that could be worth in excess of $100,000 for the employer (i.e., likely substantially more). Most employers would jump at the chance to trade off three years of health care premium  for the separating employee and spouse (i.e., a guess at the cost: $36,000 pre-tax ) against the direct and indirect payroll savings. However, there is a potential downside to the employer. If the health plan is self-funded, every claim dollar incurred by the employee or spouse below some threshold per year (i.e., varies by employer size from $50,000 to $250,000;  threshold possibly higher for jumbo sized employers) will be a direct pre-tax cost to the employer. A million dollar organ transplant can eat up the entire payroll savings very quickly. It is therefore somewhat of a roll of the dice for the employer. Note: this also applies to “experience rated” insured plans to some degree where deficits from prior years are recoverable via going-forward underwriting.

It is very important that if negotiating a bridge type agreement that spouse coverage be an absolute deal breaker. You must have it if you have a spouse of roughly equivalent age who does not have a source of health care at his/her employment or who has retired earlier. You may be able to strike an agreement whereby a Medicare eligible spouse specifies that Medicare is to be “primary” and the employer’s plan will be “secondary” in claims payment order when age 65 is attained. That lessens the possible claims impact somewhat. You can also make the argument that more than likely the employer is going to own the employee and dependent claims under most of the above scenarios (i.e., stays employed, goes on COBRA, or falls under a bridge agreement).

Many large employers have canned early retirement packages on the shelf with the above kind of provisions. Human Resources professionals should be aware of them on the local/regional level. However, if that does not appear to be the case, an inquiry at the home office level might be required. HR people should also be willing to discuss these matters “off the record” to ensure no negative behavior by supervisors.

The Minimal Employment Scenario

Lastly, the new employer alternative. Many older early-retired people find work at the minimum hours and minimum skill levels required for them to qualify for health care coverage at a new employer. It occurs frequently at the ski resorts in Colorado where formerly high powered execs are now running ski lifts, acting as mountain guides or teaching lessons. If it fits your life style, it is a consideration. If it were to cramp the post-retirement life-style you envision, it obviously would not.

 Suggested Course of Action

Set up a confidential meeting with the appropriate HR person and discretely explore your options.

Many employers are struggling to determine the precise COBRA requirements under the 2009 ARRA. Employer size, state situs of the benefit plan, specific state actions, and other things, effect the answers. In addition, where certain responsibilities have been placed on carriers, their unique administrative decisions may also drive procedures.

Below is a link to a Frequently Asked Questions (i.e., FAQ) piece on this subject provided by United Healthcare. Although some of it is specific to their own client base, much of it provides generic information that benefits professionals might find valuable as they weave their way through the huge number of variables.

This subject may also be something that in-house and contracted financial professionals need to address. Who pays the 65% COBRA subsidy and how it is ultimately recovered are key items.

Non-benefit HR types may also want to spend some time with the definitions of eligibles. Although this appears at this point to be a short-term program, the costs of which are recoverable as a credit against future payroll tax liability, certain CEO’s may want to minimize participation due to the hit on quarterly cashflow or if the company is clearly in such dire straights that a payroll tax recovery may not be viable.

Link to FAQ Resource

In mid-2008 BBCG began sending an email newsletter with various items of topical interest to benefits professionals, business owners and senior managers. As with this blog, we got somewhat distracted during the last few months with other priorities. We intend to have the next addition of The Insight out shortly. In the interim, below is a link to the archive page that contains the prior editions.

Archive link below:

http://archive.constantcontact.com/fs009/1102162493446/archive/1102248850983.html


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