UnitedHealthcare and National Restaurant Association Team Up to Create
Restaurant Health Care Alliance
UnitedHealthcare and the National Restaurant Association announced the launch of the Restaurant Health Care Alliance on May 21. This new Alliance offers a suite of products that will help restaurant employees gain easier access to health care coverage and related products and services. Today, 4 million to 6 million of the nation’s nearly 13 million food service industry employees are uninsured at any given time.
The Alliance will be available initially to state restaurant associations in Colorado and Pennsylvania , as well as insurance agents and advisers representing restaurant clients in those states. The Alliance will expand to additional states throughout 2010.
Qualified small business member restaurants will be introduced to innovative health plan options offered by UnitedHealthcare that provide significant annual premium savings compared to traditional health plans. Individual employees who do not have employer-sponsored coverage can choose from a wide range of UnitedHealthcare’s cost-effective individual and family plans, some of which start under $100 per month. Other products, including dental plans and discount health cards, will be available.
Pennsylvania Governor Ed Rendell called the initiative a critical “gap-filler” in a Los Angeles Times story. “At a time when we have one million uninsured Pennsylvanians, a program like this is very welcome,” Rendell said.

The resources and tools developed by the Alliance will be available online at www.restauranthealthcare.org.

NAHU Washington Update

In related news, many small businesses are taking issue with some of the fine print requirements that make it difficult for them to qualify for the small business health insurance premium tax credit program. In particular, there is confusion about language that prohibits business owners from counting employees who are also family members when calculating their credit. Small Business Resource

As you may recall from an earlier article on how the federal government plans to fund “their” health care reform initiative, $500 Billion was going to come from cutting health care payments to Medicare recipients across the whole system. In September of last year, The Wall Street Journal did a short article covering what we are starting to experience today.
GovernmentCare’s Assault on Seniors. – WSJ.com

The first plan to get our country to a single payer system (government run health care) was the “Public Option”. Although that option has been put on the sidelines for now, there are loop holes written in to the current reform law that will allow them to activate that option later if necessary. However, it no longer seems as if it will be necessary as their current plan seems to be achieving the same outcome. The Washington Post said it best when describing the road our government was taking to achieve a single payer system through the then toted “Public Option”.

The Public Plan
“Medicare keeps costs under control in part because of its 800 pound gorilla capacity to dictate prices- in effect to force the private sector to subsidize it. Such power, if exercised in a public health option, eventually would produce a single payer system; if that’s where the country wants to go, it should do it explicitly, not by default.”
The Washington Post, Reforming Health Care 4-27-09

You see, the government no longer needs a public plan to default our system to a single payer, it needs only to destroy the current system. Medicare is the largest payer to physicians, hospitals and all your services surrounding health care. Step one, cut cash flow to all those serving our communities; starve the system. Second, increase taxes and regulations to the entire economy. Hit the insurance companies, pharmaceutical and medical equipment manufacturers the hardest. Increase regulation to the other payers in the system (health insurance companies) so that eventually they will have to get out of the business or can simply become a supplemental company on the side removing all competitors leaving just the government. Then, the stage will be set for the government to step in and be our hero and rescue (bail-out) us all from ourselves, right?

Lack Of Permanent “Doc Fix” Could Undermine Health Reform.
The AP (5/27, Alonso-Zaldivar) reports, “For the third time this year, Congress is scrambling to stave off a hefty pay cut to doctors treating Medicare patients — even as the Obama administration mails out a glossy brochure to reassure seniors the health care program is on solid ground.” Notably, the “21.3 percent cut will take effect June 1 unless Congress intervenes in the next few days.” The AMA and other physician groups say they want a permanent solution to the problem, and many doctors say they may no longer accept Medicare patients. The AP points out that this issue “could undermine key goals of President Barack Obama’s health care overhaul, which envisions using Medicare to test ideas for improving the quality of care for all Americans.”

Democrats Defend CMS Brochure Explaining New Medicare Benefits.
Politico (5/27, Haberkorn) reports, “Top House Democrats on Wednesday said they support a taxpayer-funded brochure outlining the changes in Medicare under the health care overhaul, amid growing Republican cries of propaganda.” Earlier this week, CMS “mailed the four-page brochure to over 40 million Americans who use Medicare to explain how the program will change under the reform law. Critics say the mailing is overtly partisan and contains inaccuracies about what the overhaul will do.” But, House Speaker Nancy Pelosi (D-CA), House Majority Leader Steny Hoyer (D-MD), and HHS Secretary Kathleen Sebelius “said they have a responsibility to educate people about what’s in the overhaul and what’s not.” Sebelius added, “We want to inform America’s seniors about what the act actually contains.”

The Hill (5/27, Pecquet) notes that the brochure discusses “closing the Part D ‘doughnut hole’ that requires seniors to pay full price for their drugs above a certain threshold, free preventive care, and increased efforts to combat fraud and abuse that endanger the program’s solvency.” Nevertheless, Senate Minority Leader Mitch McConnell (R-KY) “blasted the outreach efforts on the Senate floor Tuesday, pointing out that Sebelius had objected to private Medicare Advantage plans using its communications to seniors to raise concerns with the health reform law when it was being debated.” In addition, Sen. Pat Roberts (R-KS) said, “The ‘mailer is misleading, at best. … At worst, I fear it could represent taxpayer-financed government propaganda.’”

The truth can be very discouraging today and I try not to get stuck in the quicksand, however, it does remind me as a business person and an individual taxpayer, that change is needed in November. We need to stop the bad reform and start on the track of right reform. The upside to things is that we are resilient. In the last two years, I have attended meetings and have seen insurance carriers, hospitals and physicians all in one room discussing positive reform; unthinkable just a few years ago.

We need to be accountable for our life styles and behaviors (which generate over 70% of all insurance claims (health care bills)), take reform and wellness serious and get back to doing for ourselves. We have crossed the line and we need to take action. And, if you want a little more incentive, you need only to click on this site and look at the bottom line; Medicare Liabilities in REAL TIME. U.S. National Debt Clock : Real Time

What are your fellow Americans thinking; repeal it while we still can!

Public Opinion
Americans Want Repeal of Health Care Reform: A recently released Rasmussen report suggests that Americans are strongly in favor of repealing President Barack Obama’s health care reform law. Sixty percent of those polled favor repeal, while 62% believe the new legislation will increase the budget deficit.

Majority of Americans Unhappy with Reform: According to a new Quinnipiac University poll, 51% of Americans are unhappy with the new health care reform legislation and 70% are “dissatisfied” or “very dissatisfied” with the way things are going for the nation.

On January 1, 2010, there were some provisions to the Pension Protection Act (PPA) of 2006 that went into effect that will have a large impact on how you plan and pay for a long term care insurance. I think most people see the increasing need for long term care, but who can afford (especially today) to pay for it? Or, what if the care is never needed, then what? Does all that money go down the drain? Not necessarily. There are some good solutions now and with an excellent company.

I think most people today would agree that having a plan to protect family members from a long term care event is important and essential. With advancing technology, procedures and medications, people that might have died or been permanently disabled from a cardiovascular event or stroke, now can be treated and go on to live a full life. So the fact is that people today are living longer, and as we live longer, our bodies naturally begin to break down. The possibilities of needing some sort of part time care leading to full time care sometime in the future are strong. And let’s face it, if and when care is needed, you will want to have a plan and options.

Simply having the control, a professional care manager that can step in, talk to family members, show you all your different options, make recommendations and then make all the arrangements for you, is huge. Whether you need professional or non professional care at home, a combination of the two, and/or eventually around-the-clock care, life stops. Not for the one that needs the care, but for mom, dad, son, daughter, sister, brother; the rest of the family. You might think when a family member has a life changing event you can help them, but I can tell you first hand that you really can’t. You think you can and you feel you should know everything to do, but you don’t and you won’t. When you have a plan, the family member needing care gets the care they need and the family members get to keep their life (in a sense) and are able and ready to give that extra loving care and attention that is now needed.

I know that all of us would do everything within our power and call on God above, to get the help our family members need, but it does not make us stronger in fact, we get run down. Some of us can bounce back, but for other family members like the affected spouse, it can just make situations even more desperate. If you would like to get a better understanding of long term care insurance and how it works, please click General Info and that can get you started. We use many vendors for long term care and there is not one size that fits all, however, there are some great new ways to pay for it using tax free money. Tax free money that is probably sitting on the sidelines these days earning next to nothing that could be paying for your long term care premiums. Also, there is an excellent solution to the second scenario, “what if we don’t need it after-all?” Now there are some products that solve that as well; how about getting your premiums less any claims back or perhaps a built-in life policy that pays a death benefit which could be used by your children to pay the estate taxes and burial. Now that makes sense, having a long term care policy that can also act as a life insurance policy if you do use your long term care benefits; that makes the decision much easier.

You may not be able to afford it now and maybe the best you can do is have a plan; that’s ok. However, maybe, you or family members have it available in different products, stuck at a low rate of interest but you did not realize you could transfer part of it out without a tax event. It’s worth looking into. Let me know if I can help and/or if you would like to attend a seminar we will be having soon.

In an effort to help my clients and other small businesses with less than 25 full-time employees or, 50 half-time employees or, a mix that when added together totals less than 25 full-time employees, please read on.

The following will provide everything you need to know to see if your company qualifies and then also how you can apply for these credits. The information provided comes directly from the California Association of Health Underwriters (CAHU) and the IRS website. Some of you receiving this will qualify, however, many of you will not due to the low annual salary ceiling. It may help to know however, that many of the high income earners (owners and partners) are not used in determining average annual salaries (see Q&A #13). Overall, it only takes a few minutes to go through the calculation and then view the example scenarios and the Q&A section.

CAHU

Small business Health Care Tax Credits went into effect retroactive to January 1, 2010. The IRS has several documents on their website explaining in detail what is required for small employers to qualify for and get the tax credit. As mentioned, this page contains an FAQ, a chart to help determine ER eligibility, a page of basic info also, plus more articles to help employers.

Let’s make the most of every opportunity and get the best of what is available for your company. It’s important that we plan and work together to get the regulations implemented as they come up and bless your employees with the resources that are available to us. Healthier employees make better performing companies! I am excited and looking forward to doing all I can to improve lives, aren’t you?

Thanks everyone for your business and trusting in me to always do what is in your company’s best interests. Let me know how I can help and have a great day!

With that said, I have taken only the main paragraphs out with a couple links. These links will provide you with what you need to know; one detailed and one simplified. The two links in the NAHU Update are their for your reference however, and I would recommend that you just stick with those two links for now as they will provide you with the timelines and how the law will affect us all. Two quick news flash paragraphs as they are definitely interesting.

At first read, I thought the number from above ($940 Billion) and the number from below ($438 Billion) were a contradiction until I realized that the $438 Billion they were referring to was that portion of the $940 billion that would be raised from new taxes.

Here is What You Need to Know!
During the past week, NAHU has updated our detailed timeline on reform provisions as well as our simplified timeline. NAHU has also prepared a new issue brief on the Small Business Tax Credit program. These two briefs along with the new issue brief on tax credits should be very helpful as a resource and will provide you with an outline of what is to come.

I plan on meeting with each of you over the next month to review these changes and discuss how they will affect you and your business. Also, I think this can provide a solid foundation upon which we can build as these updates come in and implementation deadlines are reached. As always, if you have any questions, please contact me at 310-414-9524 or by e-mail at John@Johnrileyins.com.

We know many of you have questions about what the newly passed health care reform legislation, H.R. 3590, contains and how it will impact your business as well as individually. As a licensed agent, insurance broker and member of NAHU (the National Association of Health Underwriters), we are working hard to provide you with the information and tools (new options & strategies) to better prepare for the future.

The amount of information about the reform bills being released right now is staggering, and we feel that it is very important to make sure we analyze these measures thoroughly to help you provide the best information to your clients. Please keep in mind that the passage of this legislation is just the beginning point, and the implementation and regulatory processes surrounding these measures will take years. Right now however, is a great opportunity to start this evaluation process, stay ahead of the curve and determine your best course action.

Through-out 2009, JRINS (John Riley Insurance Services) has worked with its strategic partners (LAAHU, chambers, hospitals, physicians & industry experts) through public seminars & chamber discussions to educate businesses on what can be expected from reform and ways in which they can prepare. More than ever, businesses of all sizes (especially co.’s under 50 employees) should begin to protect themselves from what looks to be a planned government assertion on business practices through increased policies, policing and fines. It is also important to note that in a difficult economy, employers will have the added pressure to protect themselves from frivilous employee lawsuits as the Larry H. Parkers’ of the world turn their focus to the employee entitlement market which is increasingly evolving. Businesses need to take care and be prepared.

To better understand reforms planned changes, we (NAHU) have assembled two new charts to help explain the time-line for implementation of the law. The first is a very detailed chart for your reference that explains how all of the new health insurance reforms in both the Senate bill and the reconciliation bill will impact private health insurance organized by effective date. The second chart is a simplified timeline that explains how both pieces of health care reform legislation will impact you individual and/or as an employer.

Recently, A concerned client (rightfully so) wrote me asking about the notice she had just received informing her of HIPPA Obligations Amendment. She says, “I have read this through, but would greatly appreciate a translation in the simplest form! What exactly does this mean to the Employer as well as the Employee? I have seen several, what I feel are, disturbing advertisements regarding all medical information being shared by all. While this might be beneficial in many ways, I think it is also disturbing in many ways, an invasion of an individual’s privacy. Is this what this is referring to? And what are the rights/options of the Employee?

What are the rights of the employee or a better question might be, what are our individual rights concerning our health records?

My client sent over the information which is part of the economic stimulus package President Obama signed into law in February 2009. The amount of that package was $787 billion and intended to stimulate our economy and included between $19 and $24 billion for Health Information Technology (HIT). At the signing ceremony here in Denver, Obama said that digitizing the health records of Americans was “long overdue” and would help eliminate duplication and save billions of dollars. DETAILS

She writes, “It actually looks like it is the HITECH bill, all medical records to be electronically shared, and there are incentives to get doctors to participate. While in ways this could be good, I honestly hate that there will be just one more place all private information will be generally accessible! I feel like this violated patient/doctor privileges!”

I agree with her that there is real reason for concern and insure that it is done right and not just another huge government agency. Not to mention a hackers paradise and allowing our government to again take one more step towards total control over our lives!

Federal Leadership for the Nationwide Exchange of Health Information

The legislation codifies the Office of the National Coordinator for Health Information Technology (ONCHIT) within the Department of Health and Human Services. This office is responsible for creating a nationwide health information technology infrastructure aimed at improving health care quality and care coordination.

Did you know that this was going to create one huge government office (HEALTH RECORD CZAR) to oversee all our medical records housed in one place? It was this next statement that also struck me as highly suspect.

Last Par 1st page….

After standards are adopted in 2009, the National Coordinator shall make available at a nominal fee an electronic health record, unless the Secretary determines that the needs and demands of providers are being substantially and adequately met by the marketplace. Nothing in the legislation requires that entities adopt or use the technology made available through this provision.
Very Scary Stuff! Though I believe the whole industry and nation agrees that electronic medical records is a key component (huge factor) to solving many of the underlying issues that directly cause skyrocketing health care costs. Again, it’s all in the details. TechCostsPie

Though we are moving forward in some areas that will produce good reform and will lower health care costs, we need to be careful how much government is in the solution. Government must play a part, but we know when it comes to administration and control, those are areas best left (and/or given) to the private sector (our country).

H.R. 3590 contains provisions that will increase the cost of private health insurance and cause damage to our health care delivery system. The bill that passed the Senate includes billions in new taxes, a weak individual mandate that will drive up insurance premiums as people opt out of private insurance until they are sick, the expansion of Medicaid that could cripple state budgets and a new national long-term care program that has been described by Senate Budget Committee Chair Kent Conrad as a “Ponzi Scheme.”

Some facts:
• The Medicare Payment Advisory Commission released its annual report May 12, 2009 projecting that the trust fund used to pay for Medicare hospital costs will become insolvent two years earlier than the commission estimated last year.
• Our Federal Government is over 50 trillion dollars in unfunded liabilities for our Medicare system and is now projected to be bankrupt by 2017.
• Government subs out the administration of Medicare to the private sector who does the work at 5.9%, yet Medicaid, Veterans and all other public programs are administered by our government at 26%.
• Competition in a private health insurance market saves tens of billions each year that government agencies would waste on administrative cost.
• This legislation will increase health insurance rates and with a loose mandate for everyone to participate, we can expect what is happening now in New Jersey. Guarantee issue without a mandate makes for an insurance policy you only buy when your house is already on fire.
• Despite what President Obama says and the fact that your insurance premiums are going up by 10% – 12 % per year, it is not the insurance companies causing health care costs to skyrocket. Health care costs are skyrocketing across the world. If you would like the facts on how the insurance companies money is spent Vs. our largest insurance company in the nation (our Federal Government), please let me know and I will send you the information.

http://www.healthactionnetwork.com/legislatorsearch.aspx