Health Care Reform, Insurance and Employee Benefits

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Displaying posts tagged "medicare" (Clear Search)

What is HHS (Health and Human Services)?

Note: this should not be taken as tax or legal advice.

The United States Department of Health and Human Services (HHS) is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America".

Click here to visit the HHS website.

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What is CMS (Centers for Medicare & Medicaid Services)?

Note: this should not be taken as tax or legal advice.
CMS (Centers for Medicare & Medicaid Services) is the U.S. federal agency that administers Medicare, Medicaid, and the Children's Health Insurance Program. 

Click here to visit the CMS Website.

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Large Employers Are Switching to Defined Contribution Health Plans

Note: This should not be taken as tax or legal advice

Many large employers are terminating traditional defined benefit retiree plans in favor of a defined contribution approach utilizing the individual market and Medicare.  

This approach relies on health reimbursement arrangements (HRAs), which retirees can use to pay for health care expenses and Medicare Part B and Part D premiums

The following companies (among others) have already decided to make the switch:
Click the above links for details on each company's decision.

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What is an ACO (Accountable Care Organization)?

Note: This should not be taken as tax or legal advice.

Beginning in 2012, the Affordable Care Act is requiring Medicare to use Accountable Care Organizations (ACOs) in an attempt to slow the rise of health care costs.  So, what's an ACO?

An ACO is a vehicle for paying teams of health care providers to care for patients, instead of paying for care one service at a time.  An ACO limits health care providers’ financial relationships with other providers.

Proponents of ACOs argue that the programs provide:
  • Personalized care management and support
  • Technology that connects doctors with patient information and medical evidence
  • Financial incentives that reward doctors who work hard to provide good care for patients with chronic conditions and doctors whose patients’ health improves
What do you think?

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Health Reimbursement Arrangements (HRAs) and Medicare Secondary Payer Reporting

In January, 2010, the Centers for Medicare and Medicaid Services (CMS) issued a revised MMSEA Section 111 MSP Mandatory Reporting GHP User Guide which clarifes the Health Reimbursement Arrangement (HRA) reporting requirements for Medicare Secondary Payer. 

Click here to access the most recent alert put out by CMS.

Who is required to report HRA plans?

If you self-administer your HRA, you will be responsible for submitting the Section 111 information on behalf of those plans. Otherwise, the third party administrator (TPA) may file on your behalf.

When is reporting required?

HRA-only Responsible Reporting Entities (RREs) were expected to register by May 1, 2010 in order to complete the registration process by June 30, 2010.  There will be a testing period from July 1st, 2010 until September 30th, 2010. 

Beginning October 1st, 2010, reporting with begin.

Other Key Things to Note:
  • HRAs offered in conjunction with a group health plan should not be reported separately from the group health plan coverage. 
  • HRAs with annual benefit amounts less than $1,000 are exempted from reporting requirements

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Who we are...
Clarifying Health is a blog about health insurance, health benefits, and everything else related to how Americans pay for medical expenses.

If you have any tips or suggestions for this blog, send an email to blog@ZaneBenefits.com and let us know. We always appreciate feedback

We also run a company called Zane Benefits where we're doing everything we can to help America out of the current healthcare mess.

If you want to learn more about how Zane Benefits helps companies with their benefits, or you're interested in working with us, visit the Zane Benefits website.
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