February 2009

In This Issue

 

Their Health, Your Premium, Our Plan

The NCMS Plan Wellness Initiative

As a practice manager, you face the dual challenges of decreasing revenues and increasing costs of doing business. Balancing that equation in regards to your employee health benefit coverage is increasingly difficult. While many participating physician practices have reduced the level of benefits offered and/or increased the employee contribution towards benefits, practices continue to see rising benefit costs.

Rising benefits costs within the NCMS Plan are being driven by (i) general increases in the price of medical services, (ii) medical expenses associated with high cost claimants, and (iii) pharmacy costs. Taking action in these areas will help to control these ever-rising costs.

The NCMS Plan is committed to helping you control the increasing costs of employee health benefits coverage with information, programs and resources.

As a leader within your practice, you are uniquely positioned to help educate your employees about the relationship between their health, the premium they pay, and the ultimate cost of health benefit coverage to the practice. And the NCMS Plan is here to support you in that effort with information, programs and resources to help your employees improve their health and manage their chronic medical conditions.

Upcoming "special" editions of CHOICES will provide more information about the NCMS Planís Wellness Initiative. Contact your NCMS Plan representative with any questions or requests for assistance in promoting wellness and chronic disease efforts within your practice.

Partnering with you, we can encourage healthier lifestyles and control costs with wellness programs that work.

Preventive Care Reminders

The NCMS Plan administrator, BCBSNC, has implemented a new Preventive Services Reminder program. The Reminder sent to members incorporates seven preventive health screenings recommended by the US Preventive Services Task Force including mammograms, pap smears, and colon cancer screenings. The reminders are member-specific, highlighting those specific screenings for which the member is overdue.

Mailed each month to members with an upcoming birthday, the reminders feature a tear-off portion listing those screenings for which a member is overdue, with an accompanying "Date Scheduled" write-in column to aid members in scheduling needed appointments.

Group Insurance Continuation

Did you know that your employees may be eligible to continue their group insurance coverage if their employment ends or if they are no longer eligible for benefits? The following is the first part of a two-part series providing a snapshot of the continuation provisions mandated at the federal and state level. As the employer, you are responsible for understanding these laws and meeting the obligations outlined. For more complete continuation information, visit the U.S. Department of Labor or the North Carolina Department of Insurance.

Part One: Consolidated Omnibus Budget Reconciliation Act (COBRA)

All employers who normally employed 20 or more employees on at least 50 percent of its working days during the prior calendar year are covered by COBRA. Individuals and eligible dependents provided insurance under the employer's group health plan are entitled to elect COBRA coverage upon the occurence of a "qualifying event" that results in the loss of coverage. A "qualifying event" may include, but is not limited to, the following:

  • a reduction in hours
  • the termination of employment (unless for gross misconduct)
  • the death of a covered employee
  • a divorce or legal separation
  • a child is no longer a dependent

A covered employer must give each employee and spouse covered under the plan a general notice of what COBRA is and their rights under COBRA within 90 days of initial coverage. Employers must also notify their plan administrator (the NCMS Plan) of a qualifying event within 30 days. The eligible employee then has 60 days to decide whether to elect COBRA continuation coverage. The 60 day period is measured from the later of the date coverage terminates or the date the "qualifying event" notice is given. If the employee elects COBRA, the employer must notify the plan administrator so the employee can be reinstated as a continuant.

Coverage can continue for up to 18 months after an employee's termination or reduction in hours. For any other qualifying event, coverage may be continued for up to 36 months.

Coverage can be terminated by the group health plan if premiums are not paid in full by the continuant on a timely basis and/or continuant gets health coverage under another group health plan.

The NCMS Plan provides COBRA administration services through Ceridian. These services include initial COBRA eligibility notification, notification of qualifying event and right to elect COBRA, as well as administration of billing and collecting COBRA premium. If you are covered by COBRA and interested in Ceridian's services (at no additional cost), please contact us for more information, 1-800-662-7917.

In the next issue of CHOICES, we will explore the North Carolina law governing continuation.

Ask George

Question: We recently enrolled as a new practice with the NCMS Plan and want to be certain that future employee enrollments and changes are processed quickly and accurately. What is the best way to send you our NCMS Plan health insurance enrollment and change information?


Answer: On a typical day at the NCMS Plan, we receive a substantial volume of health insurance enrollment and administrative documentation. The NCMS Plan Employee Enrollment Application and Change Form is used for indicating any enrollment information subsequent to your practice's initial enrollment. This form is available at http://www.medicalmutualgroup.com/mmic/employee_benefits/applications_and_forms.html. Remembering to include some key items on the form will make any enrollment or change process quickly and smoothly. Always write your six-digit group number in the upper right hand corner of the application in the shaded area entitled "Completed by Group Administrator Only". In this same area, also complete the Effective Date of the enrollment or change being made.

If making a change, Section A. has the most common change options with a box that can be checked. Just select the change you need processed. Completing Section B. will ensure your employees are enrolled on the right plan and type of coverage. Section C. has the indispensible employee birthdate, hire date, name & address as well as a field for employer name. Applicants should indicate any dependents to be covered in Section D. Complete Sections E. & F. to show any prior coverage or coordination of benefits with another carrier.

In Section G., an employee can name a beneficiary for the NCMS Plan life coverage (if offered) and, finally, have the employee sign the form for validation.

For most efficient processing, forwarding the form to our dedicated enrollment representative at BCBSNC is your best course of action. You can submit any health insurance enrollments and changes directly to BCBSNC, ATTN: Kim Pryor (fax) 919-765-3564 or (e-mail) ncms@bcbsnc.com.

Be Sure to Complete the Customer Survey

The NCMS Plan has mailed a customer survey to solicit your feedback. The requested response date has been extended. The short survey will take 5-10 minutes to complete. The information is a valuable resource for ensuring that the NCMS Plan stays on the right track and continues to meet your expectations. Thank you in advance for your participation.

This year, the survey highlights employee wellness. Our focus in 2009, as indicated in an article above, will be health and wellness and promoting available resources to your employees to help them improve their health and contain medical costs. The questions relate to what you and your employees know about health and wellness resources available through the NCMS Plan and our plan administrator, BCBSNC, and what activities or programs you may already have in place. Your feedback will help set a benchmark that we hope to see rise over the next year and beyond.

Mellon Announces Change to HSA Interest Rate

Effective February 1, 2009, the interest rate paid on Mellon HSA checking accounts changed from 0.500% to 0.250%. This change will appear on bank statements that Mellon HSA customers receive beginning in early March. The last rate adjustment was April 1, 2008 and Mellon was able to sustain that rate for the last 10 months, despite falling interest rates. While the reality of the current economic climate requires this action, Mellon will continue to closely monitor interest rates and make responsive adjustments.

An updated fee sheet can be found at http://www.medicalmutualgroup.com/mmic/media/pdf/ncmedsoc_plan/BlueOptionsHSA_Fees071008.pdf.

Changes to Wellness Discount Programs

The NCMS Plan's administrator, BCBSNC, is making changes to the wellness discount programs available to all BCBSNC members. Effective April 1, 2009, discounts will be available to Gold's Gym, Curves, eDiets.com, Kronos, and LA Weight Loss. Other discounts available include:

  • Chiropractic discounts
  • Vitamins and supplements
  • Vision and LASIK discounts
  • Hearing aids

The following discounts will be discontinued effective April 1, 2009, due to underutilization:

  • Cosmetic surgery
  • Cosmetic dentistry
  • Alternative medicine services, including acupuncture, massage therapy, personal trainers, tai chi, and yoga

About the North Carolina Medical Society

As the largest physician organization in the state, the North Carolina Medical Society (NCMS) is devoted to representing the interests of physicians and protecting the quality of patient care. The NCMS Plan, sponsored by the NCMS, is the only statewide employee benefits plan designed specifically for North Carolina physicians.

For more information about many other benefits of NCMS membership, visit http://www.ncmedsoc.org/.

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