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mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="1026"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body bgcolor=whitesmoke lang=EN-US link="#01466C" vlink="#01466C" style='tab-interval:.5in'> <div class=Section1> <p class=MsoNormal style='margin-left:120.0pt;text-indent:-120.0pt;tab-stops: 120.0pt;mso-layout-grid-align:none;text-autospace:none'>&nbsp;</p> <p class=MsoNormal style='margin:0in;margin-bottom:.0001pt'><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><br> </span></p> <div align=center> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 width=578 style='width:433.5pt;mso-cellspacing:0in;border:solid #6CADDF 1.0pt; mso-border-alt:solid #6CADDF .75pt;mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style='border:none;padding:0in 0in 0in 0in'> <p class=MsoNormal style='margin:0in;margin-bottom:.0001pt'><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><img width=600 height=300 id="_x0000_i1026" src="http://mmg2.signal-mail.com/ncmsplan/images/header_choices.jpg" border=0 NOSEND=1><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td style='border:none;background:white;padding:3.75pt 15.0pt 15.0pt 15.0pt' id=content> <p align=right style='text-align:right' id="volume_issue"><strong><span style='font-family:"Helvetica","sans-serif";color:#636466'>Health Care Reform Edition</span></strong><span style='font-family:"Helvetica","sans-serif"; color:#636466'> <o:p></o:p></span></p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt: 0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td valign=top style='padding:0in 0in 0in 0in'> <h2 id=top><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>In This Issue<o:p></o:p></span></h2> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#PPACA_Compliance_and_the_NCMS_Plan">PPACA Compliance and the NCMS Plan</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Coverage_of_Preventive_Health_Services">Coverage of Preventive Health Services</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Extension_of_Dependent_Coverage">Extension of Dependent Coverage</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Temporary_Reinsurance_Program_for_Early">Temporary Reinsurance Program for Early Retirees</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#No_Lifetime_or_Annual_Limits_on_Essenti">No Lifetime or Annual Limits on Essential Benefits</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Prohibition_of_Pre-existing_Condition_E">Prohibition of Pre-existing Condition Exclusions</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Guaranteed_Availability_and_Renewabilit">Guaranteed Availability and Renewability</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#The_Grandfather_Rule_and_the_NCMS_Plan">The Grandfather Rule and the NCMS Plan</a> <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom: 0in;margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list: l1 level1 lfo1;tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt;mso-bidi-font-size:9.0pt;font-family:Symbol; mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family: "Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'><a href="#Health_Promotion_and_Rewards">Health Promotion and Rewards</a> <o:p></o:p></span></p> </td> <td style='padding:0in 0in 0in 0in'> <p class=MsoNormal style='margin:0in;margin-bottom:.0001pt'><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family:"Times New Roman"; color:#636466'>&nbsp;<o:p></o:p></span></p> </td> <td valign=top style='padding:0in 0in 0in 0in'></td> </tr> </table> <div class=MsoNormal align=center style='margin:0in;margin-bottom:.0001pt; text-align:center'><span style='font-family:"Helvetica","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#636466'> <hr size=4 width="100%" noshade style='color:#F7941D' align=center> </span></div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>PPACA Compliance and the NCMS Plan<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>Health care reform became a reality when two bills were signed into law in March: the Patient Protection and Affordable Care Act (PPACA) and its companion legislation, the Health Care and Education Reconciliation Act of 2010. <br> <br> The law includes numerous health-related provisions to take effect over a four-year period, including expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage/claims based on pre-existing conditions, establishing health insurance exchanges, and support for medical research. <br> <br> This &quot;Health Care Reform Edition&quot; of <u>CHOICES</u> is designed to inform NCMS Plan practices of reforms that are relevant to the NCMS Plan. We will highlight which provisions the NCMS Plan are already in compliance, and if not, when it will be compliant. Bear in mind that NCMS Plan practices renew throughout the year and that individual practices will not see these changes until their first renewal after provisions are adopted. <br> <br> The NCMS Plan closely monitors healthcare legislation and will continue to ensure that the products offered comply with PPACA and that our participating practices understand the impact on their benefits, their practice, and their employees and dependents. We hope that you will find this information useful and answer some of the questions that you have regarding PPACA and the NCMS Plan. If you have additional questions, please contact your NCMS Plan agent or call (800) 662-7917.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Coverage of Preventive Health Services<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>PPACA dictates that plans must provide coverage without cost-sharing for preventive care and medical screenings recommended by several prominent panels, including the US Preventive Services Task Force and the Centers for Disease Control effective September 23, 2010. The NCMS Plan became compliant with this requirement beginning with coverage effective dates October 1, 2010 and after. <br> <br> However, it is worth noting that the HDHP and HRA products currently offered by the NCMS Plan were already in compliance with this requirement. Both offer an enhanced preventive service benefit without cost-sharing (no copayment, deductible, or coinsurance) for preventive care and screenings. This leaves only the NCMS Plan's PPO and PPO 1-2-3 products which will no longer subject preventive services to copayments or deductibles. Individual practices will see this change at their first renewal October 1, 2010, and after.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Extension of Dependent Coverage<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>Plans that provide dependent coverage must extend coverage to adult children up to age 26. The NCMS Plan currently offers coverage to <u>unmarried</u> dependent children to the end of the month of their 26th birthday. Both the PPACA requirement and NCMS Plan's current eligibility provisions make student-status irrelevant. <br> <br> Effective October 1, 2010, and upon individual practice renewals thereafter, the NCMS Plan has expanded its eligibility definition as required to include <u>married</u> dependent children. However, PPACA does not require the coverage of adult children who are eligible for their own employer-sponsored coverage.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Temporary Reinsurance Program for Early Retirees<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>PPACA provides $5 billion in financial assistance to employers, unions and state and local governments to help them maintain coverage for early retirees age fifty-five (55) and older who are not yet eligible for Medicare. Employers with self-funded and fully-insured plans are eligible, including private companies, nonprofits, religious organizations, unions operating employee benefit plans, and other employer-sponsored benefit plans. <br> <br> Medical claims for early retirees age fifty-five (55) and older who are not yet eligible for Medicare, and the medical claims of their spouses, surviving spouses, and dependents, are eligible for reinsurance reimbursement. Health benefits claims that qualify for relief include medical, surgical, hospital, prescription drug, and other benefits that may be specified by the Secretary of Health and Human Services ( HHS ), such as coverage for mental health services. The amount of this reimbursement is up to 80 percent of medical claims costs for health benefits between $15,000 and $90,000. <br> <br> The NCMS Plan, on behalf of all of its participating employers, has been approved to participate in the Early Retiree Reinsurance Program ( ERRP ). The NCMS Plan will submit requests for any eligible reinsurance reimbursements to HHS on behalf of its participating employers. Any reinsurance reimbursements received by the NCMS Plan will be credited against the individual employer s claims account. <br> <br> Employers participating in the NCMS Plan have the right to opt-out of this joint filing, and to apply individually with HHS to participate in ERRP. <br> <br> What do you need to do?<o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom:0in; margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt; mso-bidi-font-size:9.0pt;font-family:Symbol;mso-fareast-font-family:Symbol; mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#636466'>Ensure that all early retirees are properly enrolled with the NCMS Plan. Contact George Fanelli at <a href="mailto:george.fanelli@mmicnc.com">george.fanelli@mmicnc.com</a> or (919) 878-7561 to confirm this information. <o:p></o:p></span></p> <p class=MsoNormal style='margin-top:0in;margin-right:0in;margin-bottom:0in; margin-left:15.0pt;margin-bottom:.0001pt;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in'><![if !supportLists]><span style='font-size:10.0pt; mso-bidi-font-size:9.0pt;font-family:Symbol;mso-fareast-font-family:Symbol; mso-bidi-font-family:Symbol;color:#636466'><span style='mso-list:Ignore'><span style='font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><![endif]><span style='font-size:9.0pt;font-family:"Helvetica","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#636466'>Notify the NCMS Plan if you choose to opt-out of the joint filing. Send your notice to Gary Bossert at <a href="mailto:gary.bossert@mmicnc.com">gary.bossert@mmicnc.com</a>. <o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>No Lifetime or Annual Limits on Essential Benefits<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>Under PPACA, insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014. Plans may still impose annual or lifetime limits on specific covered benefits that are not essential. &quot;Essential benefits&quot; have not yet been defined, but the Department of Health and Human Services (HHS) has said that they will &quot;take into account good faith efforts to comply with a reasonable interpretation of the term.&quot; <br> <br> The NCMS Plan is already in compliance with this requirement. Lifetime or annual limits are not imposed on &quot;essential benefits&quot;, based on a reasonable interpretation. Insurers not already compliant will be required to increase their annual limits by set amounts until 2014 when no caps can be imposed.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Prohibition of Pre-existing Condition Exclusions<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>Under PPACA, a health plan may no longer impose pre-exisiting condition exclusions; first for individuals 19 and under (effective September 23, 2010), and for all others beginning January 1, 2014. <br> <br> Effective October 1, 2010, and upon individual practice renewals thereafter, the NCMS Plan is in compliance with the provision for individuals age 19 and under and will comply with the requirement for all others beginning January 1, 2014.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Guaranteed Availability and Renewability<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>PPACA requires insurers to accept every employer that applies for coverage and renew coverage for those already covered effective January 1, 2014. The NCMS Plan has always provided, and will continue to provide, guaranteed coverage for and renew every medical practice in North Carolina that qualifies for participation.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>The Grandfather Rule and the NCMS Plan<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>The &quot;grandfather&quot; rule implements the grandfather provision of PPACA enabling employers to keep their plan while adding important new benefits for the employees covered by the plan. <br> <br> PPACA requires all health plans (including the NCMS Plan) to provide the important new benefits already addressed in this newsletter including extension of parent's coverage to young adults under age 26. However, it allows employers with coverage that existed on March 23, 2010, to make routine changes without losing grandfather status. If an employer chooses to significantly cut benefits or increase out-of-pocket spending for employees, the employer will lose their &quot;grandfather&quot; status. <br> <br> &quot;Grandfathered&quot; plans may benefit from an exception from certain insurance market reforms and coverage mandates. However, it is important to note, again, that &quot;grandfathering&quot; does not protect an employer from the reforms found in parts of the statute addressed previously, nor will the provisions adopted by the NCMS Plan to this point jeopardize an employer's ability to maintain &quot;grandfathered&quot; status. <br> <br> The NCMS Plan will continue to offer products that are compliant with PPACA and design benefit plans that meet the needs of the most practices. The NCMS Plan cannot guarantee that a plan currently offered by your practice will remain unchanged or continue to be offered if market trends and financial considerations deem a change necessary. <br> <br> For more information about the &quot;grandfather&quot; rule, visit <a href="http://mmg2.signal-mail.com/emailmanager/LinkCapture?messageSendQueueId=50583&amp;link=http%3A%2F%2Fwww.healthcare.gov%2Fnews%2Ffactsheets%2Fkeeping_the_health_plan_you_have_grandfathered.html">www.healthcare.gov</a>.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h1><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>Health Promotion and Rewards<o:p></o:p></span></h1> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>Health promotion and disease prevention programs that base the conditions for obtaining a premium discount or any other reward upon a health status-related factor must limit such rewards to 30% of the cost of coverage. The Secretaries of HHS, Labor and Treasury may increase the cap on rewards up to 50% if deemed appropriate. Wellness programs must be reasonably designed to promote health or prevent disease and must give eligible individuals the opportunity to qualify for the reward at least once per year, and rewards must be made available to all similarly situated individuals. <br> <br> The NCMS Plan's health promotion and disease prevention programs are in compliance with these requirements. Our Health Promotion Coordinator, Jason Horay, will consult with participating employers to help ensure that their health promotion programs and disease prevention programs are also in compliance. For more information about the NCMS Plan's health promotion programming and to schedule a consultation, contact Jason at (919) 878-7530 or <a href="mailto:jason.horay@mmicnc.com">jason.horay@mmicnc.com</a>.<o:p></o:p></span></p> <div style='mso-element:para-border-div;border:none;border-bottom:solid #6CADDF 1.0pt; mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in 0in 0in 0in'> <p style='border:none;mso-border-bottom-alt:solid #6CADDF .75pt;padding:0in; mso-padding-alt:0in 0in 0in 0in'><span style='font-family:"Helvetica","sans-serif"; color:#636466'><a href="#top"><span style='color:#6CADDF;text-decoration: none;text-underline:none'>Back to Top </span><span style='font-family:"Cambria Math","serif"; mso-bidi-font-family:"Cambria Math";color:#6CADDF;text-decoration:none; text-underline:none'>'"</span></a> <o:p></o:p></span></p> </div> <h2><span style='font-family:"Helvetica","sans-serif";mso-fareast-font-family: "Times New Roman"'>About the North Carolina Medical Society<o:p></o:p></span></h2> <p><span style='font-family:"Helvetica","sans-serif";color:#636466'>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. <br> <br> For more information about many other benefits of NCMS membership, visit <a href="http://mmg2.signal-mail.com/emailmanager/LinkCapture?messageSendQueueId=50583&amp;link=http%3A%2F%2Fwww.ncmedsoc.org%2F">www.ncmedsoc.org</a>.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td width="100%" style='width:100.0%;border:none;border-top:solid #6CADDF 4.5pt; padding:7.5pt 0in 7.5pt 0in' id=footer> <p class=MsoNormal align=center style='margin:0in;margin-bottom:.0001pt; text-align:center'><span style='font-size:8.5pt;font-family:"Helvetica","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#636466'> 2011 North Carolina Medical Society Employee Benefit Plan. All rights reserved.<br> PO Box 97968 Raleigh, NC 27624<br> 919.872.7117&nbsp;|&nbsp; 800.662.7917&nbsp;|&nbsp; 919.878.7590 FAX&nbsp;|&nbsp; <a href="http://mmg2.signal-mail.com/emailmanager/LinkCapture?messageSendQueueId=50583&amp;link=http%3A%2F%2Fwww.medicalmutualgroup.com%2Fmmg%2Flegal.html">Disclaimer</a>&nbsp;|&nbsp; <a href="http://mmg2.signal-mail.com/emailmanager/LinkCapture?messageSendQueueId=50583&amp;link=http%3A%2F%2Fwww.ncmsplan.com">www.ncmsplan.com</a><o:p></o:p></span></p> </td> </tr> </table> </div> </div> </body> </html>