January 2010

In This Issue

 

Mammogram Screening Guidelines Cause Confusion

In November, the federally funded U.S. Preventive Services Task Force issued a report indicating that routine mammograms were not necessary for women in their 40s who have normal cancer risk. Specifically, the panel said the downsides of mammograms could outweigh the benefits for many women in their 40s. The report was controversial and, after years of urging women to get annual mammograms, many doctors and patient groups joined forces to counter the new federal guidelines. The health overhaul bill now working its way through Congress may effectively nullify the new guidelines by promising mammogram coverage for women starting at age 40.

The NCMS Plan has no plans to change its current screening mammogram provisions. The NCMS Plan's PPO products cover one screening mammogram per female member per calendar year beginning at age 35 subject to a copayment. More frequent or earlier mammograms will be covered as recommended by a doctor. The NCMS Plan's HDHP/HRA products cover screening mammograms 100% in-network, not subject to copayment, deductible or coinsurance. If a screening mammogram is abnormal, or treatment is required, these services will be subject to the deductible and coinsurance. This is a summary of preventive mammograms. For a more detailed description of this benefit including all terms and conditions, please refer to your benefit booklet.

Women should always discuss the appropriateness of various health screening tests with their personal physicians, based on their individual health histories. The NCMS Plan recognizes and respects the importance of the relationship between our members and their health care professionals in making these decisions.

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2010 HSA Contribution Limits

The IRS recently released the 2010 cost-of-living adjustment for Health Savings Account (HSA) contribution limits.

Employees who have "employee only" coverage are eligible to contribute $3,050 to their HSAs. This has increased from the 2009 limit of $3,000. Employees with "family coverage" are eligible to contribute $6,150 to their HSAs, which is an increase over last year's maximum of $5,950. Family coverage is defined as coverage for an eligible individual and at least one other individual. Individuals can make contributions to an HSA for 2009 until April 15, 2010.

The annual "catch up" contribution for those HSA-eligible individuals who are age 55 or older remains set at $1,000. For those individuals age 55 or older under "employee only" coverage, the 2010 contribution limit is then $4,050. Those individuals age 55 or older with "family coverage" can only contribute up to $7,150 for 2010.

For more information about HSAs please contact your account representative or call us at 800-662-7917. If your employees have established HSAs through Mellon, you may also contact them directly with questions. Mellon has a dedicated employer support line, 866-712-4551.

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Group Life Through the NCMS Plan

Did you know the NCMS Plan offers group term life coverage?

Employers participating in the NCMS Plan can choose from a wide variety of plans:

  • Single flat options in the amounts of $15,000, $25,000, $30,000, $50,000 or $75,000
  • Dual flat options: a combination of two flat options giving employees the choice of a higher coverage amount
  • Salaried option: 1x, 2x, or 3x salary
  • Guaranteed issue amounts: up to $50,000 for flat options and up to $150,000 for salaried options (maximum of $250,000).
  • Accidental Death & Dismemberment (AD&D) coverage is included when you purchase one of the life options.

The NCMS Plan requires 100% employee participation including those employees declining health, and the premium is 100% employer paid. Practices offering the dual flat option can charge employees the difference in premium between the low and high option.

When choosing life coverage through the NCMS Plan you get the convenience of integrated billing. Your practice will receive one monthly billing statement for both your health and life coverage, which means you only have to write one check. NCMS Plan group term life coverage is underwritten by USAble.

For more information about NCMS Plan group term life coverage, please contact your account representative, call 800-662-7917, or visit www.ncmsplan.com.

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Update on COBRA Subsidy Extension

As expected, Congress and the President extended and expanded the COBRA premium subsidy, allowing a greater number of individuals to take advantage of federal assistance and introducing additional COBRA notice and administrative requirements for employers.

The new legislation, part of the Department of Defense Appropriations Act of 2010, extends the COBRA subsidy’s eligibility period for two months and extends the maximum duration of the federal assistance from nine months to 15 months. It also provides additional notification requirements.

Changes under the new subsidy extension provision:

  • The end date of eligibility for the ARRA subsidy changes from December 31, 2009, to February 28, 2010.
  • The ARRA premium subsidy expands to 15 months, increased from current nine months.
  • Participants whose subsidy ran out and who did not pay the full premium will get a second chance to opt for coverage. For example, a participant whose nine months of subsidized coverage ran out November 30 and who did not pay the regular unsubsidized December premium could pay the 35 percent premium share in January and receive coverage for December.
  • Involuntary terminations that occur on or before February 28, 2010, would be eligible for the subsidy, regardless of when the individual's COBRA eligibility period begins. This addresses a Congressional oversight in the original bill pertaining to December 31, 2009, Qualifying Events.

Ceridian will continue to guide practices through administrative changes resulting from the extension. As Ceridian did for the original COBRA subsidy provision in the American Recovery and Reinvestment Act of 2009 (ARRA), they will answer your questions about the COBRA subsidy and explain how they will manage the new legislative requirements. If your practice is currently using Ceridian's COBRA administration services, you can contact them directly for support at 1-800-488-8757.

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.

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Ask George

Question: We have an employee that has been with our practice for many years who will be retiring soon but won't be eligible for Medicare for several years. She would like to maintain coverage but COBRA will not extend coverage for this employee beyond 18 months. What options does she have until she is eligible for Medicare?

Answer: The NCMS Plan has made a special eligibility class available for physician and non-physician retirees to keep their group health coverage until they are eligible for Medicare. A practice has the option of offering this retiree coverage or not.

The criteria for eligibility differs for physicians (MD's) and non-physicians (all other staff) but hinges on the practice's continued participation in the NCMS Plan and the individual not becoming eligible for another group's health plan.

Physicians can elect the retiree coverage at any age and at any time as long as they were a member of the NCMS Plan immediately prior to retirement, maintain membership in the NC Medical Society after retirement and do not become eligible for any other subsequent group health plan.

Retired non-physician employees must meet the following criteria: the employee must be at least age 55, be employed by the participating employer for at least 10 years, and be a member of the NCMS Plan immediately prior to retirement. If these criteria are met, the employee is eligible for continued until Medicare eligibility.

Retiree benefit elections for eligible physicians and non-physicians should be submitted to the NCMS Plan on group letterhead indicating member information and date of retirement. You will receive written confirmation of receipt and the member will continue to appear on your group billing statement. If you have questions or would like to review your retiree coverage options, please contact me at 919-878-7561 or george.fanelli@mmicnc.com.

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Customer Survey Coming Soon

The NCMS Plan will soon mail its annual customer survey to solicit your feedback. The requested response date is February 12th. This brief 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.

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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 www.ncmedsoc.org.

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