JUNE 2012
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Wellness
211 Grandview Drive
Fort Mitchell, KY 41017
859.331.3232
859.578.7793 fax
866.823.3814 toll free
The Business Benefits Insurance Solutions Team
Our Advisors
George Beatrice CLU, RHU
Gary Beatrice, JD, RHU
Jim Beatrice, RHU
Geralyn Isler
Chris Spicker
Lisa Roark
Ron Bechtol
Terri Jacobson
Lee Arkenau
Jim Garner, CPCU
Brian Garner
Our Staff
Rose Beckner
Kim Romer
Renee Henry
Nicole Dornbusch
Alicia Gunning
Matthew Garner
Amy Arnold
Alex Lewin /
Today’s Headlines
IndustryNews: Supreme Court RulingExpanded Preventive Coverage for Women
MLR Rebates and Notice Requirements
HSA Contribution Limits for 2013
FSA $2500 Limit- New Guidance
Contact your advisor for more information or to schedule a meeting. Email links are provided in the left margin of this newsletter.
News
Supreme Court Upholds the Health Care Law’s Individual MandateOn June 28, 2012 the Supreme Court released their decision to uphold the health care law’s individual mandate and therefore the majority of the Affordable Care Act.
However one of the arguments the States had against the law was whether Congress improperly expanded the Medicaid program, which is state run and partially financed by each state. The court ruled that Congress cannot “penalize States that choose not to participate in that new program by taking away their existing Medicaid funding,” Chief Justice Roberts said. The impact of this decision on employers is currently unknown. Supreme Court Opinion on The Affordable Care Act
Washington Post
The Wall Street Journal
The New York Times
As a result of this long awaited decision it is more important then ever for employers to prepare and comply with the law. Business Benefits Insurance Solutions promises to continue to stay at the forefront of all legal and regulatory changes. Please see the information below for important updates.
Expanded Preventive Coverage for Women
U.S. Department of Health and Human Services (HHS) announced last August the new guidelines, developed by the Independent Institute of Medicine, that require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible. Most new and non-grandfathered plans will need to include these benefits beginning on and after August 1, 2012.
Guidelines for Women’s Preventive Coverage
See fact sheets from:
Anthem
United HealthCare
MLR Rebates and Notice Requirements
This provision of the Affordable Care Act requires insurers to report plan costs for the purpose of calculating the insurers' medical loss ratio (the percentage of insurance premium dollars spent on reimbursement for clinical services and activities to improve health care quality).
Large group insurers must spend at least 85 percent of premium dollars on claims and activities to improve health care quality. Individual and small group insurers must spend at least 80 percent of premium dollars on claims and activities to improve health care quality.
The calculations are based on the aggregate experience of the insurer for each state in which the insurance carrier is licensed.
By August 2012, health insurers must provide notices and/or rebates to enrollees if their medical loss ratio does not meet the minimum standards for the 2011 plan year.
Although it’s the responsibility of the insurers to calculate the medical loss ratio as well as to send out notices and rebates, employers must be prepared to determine the proper allocation of the rebate dollars to health plan participants. Health plan participants are entitled to a portion of the rebates based on their percentage share of health plan premiums paid. For example, employers who charge employees 50% of the health plan premiums will be responsible for allocating 50% of the rebate dollars to participants. MLR Rebate Calculator (provided by Anthem)
Read the below notices for guidance on how rebates can be distributed and possible tax consequences of distributions.
U.S. Department of Labor Technical Release
IRS FAQs
United HealthCare Early Warning Report indicates Kentucky large group UHC clients and Ohio small group UHC clients should expect small rebates.
We do not yet have indications from the other carriers as to whether they anticipate issuing rebates.
HSA Limits for 2013
Starting January 2013 HSA Contribution Maximums are increasing, as announced by the U.S. Treasury and the IRS. IRS Notice
Maximum HSA Bank Account Contributions:
2012 2013
Single: $3,100 Single: $3,250
Family: $6,250 Family: $6,450
Catch up contributions will continue to be $1,000 per individual for those age 55 or older.
Contributions may be pre-taxed if offered through a cafeteria plan or are tax deductible. For partners in a partnership, shareholders who own more than 2% stock in a Sub S Corp, and members of an LLC, please refer to your tax advisor.
FSA $2500 Limit - New Guidance
On May 30, 2012 the IRS announced new guidanceon the $2,500 maximum contribution limit for Healthcare Flexible Spending Accounts, which goes into effect in 2013. This new guidance now states:
- The new limit only applies to plans with a plan year beginning date of January 1, 2013 or later
- The $2,500 limit restarts each plan year, rather than each calendar year
- Any short plan years that start after January 1, 2013 mustprorate the $2,500maximum contribution limit
- The maximum contribution limit isapplied on an employee-by-employee basis and is applied separately for each unrelated employer that an individual may be working for during the year. So it is possible for an individual to contribute more than $2,500 if two or more unrelated employers employ them.
Wellness at Work
For our recent Wellness at Work newsletters see the links below.Wellness at Work- July 2012
Wellness at Work- June 2012
Property & Casualty
BUSINESS INSURANCECommercial Umbrella: Protecting Your Business Assets
Catastrophic claims are difficult to predict and can deliver a crippling blow to your business if the exposures are not properly covered. One way to provide peace of mind for you and your business is to purchase a commercial umbrella policy.
Do you know that every owner of a commercial operation, whether it is a retail store or a concrete contractor, runs the risk of suffering a catastrophic liability loss? Not all of these losses can be anticipated. For example:
Insured performed tire work on claimant’s trailer. While being pulled by the claimant, the tire came off the trailer, crossed the median and caused a fatality loss in oncoming traffic. ($2 million paid)
Insured’s employee, driving his own vehicle in the course of employment, struck the claimant’s vehicle, causing serious bodily injury to the claimant. ($1 million paid)
As a result of insured contractor’s negligence, the county 911 phone system was disabled for several hours. ($1,191,171 paid)
A commercial umbrella policy is designed to be broader than your commercial auto or general liability policy, and can provide coverage where those policies would not. For example, a commercial umbrella will:
Provide defense coverage if your auto or liability polices don’t cover a claim.
Cover your business for personal injury exposures such as libel, slander, defamation of character, humiliation, and discrimination.
Provide coverage for property rented to, used by, or in the care, custody and control of the insured.
Are you protecting your commercial operation to the fullest? Contact our office about a commercial umbrella for your business.
Jim Garner, CPCU, MBA
Business Benefits Insurance Solutions: News and Updates
Team UpdatesCongratulations to Lisa Roark, who is a 2012 graduate of Leadership Northern Kentucky!
Good luck to Bob Beatrice in his new venture with the Bob Beatrice Insurance Agency.
Links to previous newsletters:
Insider Update- April 2012
Insider Update- January 2012
Insider Update- November 2011
Insider Update- August2011
Please check our website, , for additional news and information.
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