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Each year, prior to Medicare’s Annual Election Period, employers must send notices of creditable coverage to all employees over age 65 (or any other employee or dependent otherwise eligible for Medicare).  What is creditable coverage? If a health insurance plan (in this case, a group policy) is expected to pay, on average, as much as a standard Medicare Part D policy, that is called “creditable coverage”. It means that the prescription drug benefits of a healthcare plan is at least equivalent in coverage to what Medicare Part D plans would offer.  What must the notice of creditable coverage communicate? Prior to October 15 each year, employers must supply written notice to all  Medicare-eligible employees COBRA-covered individualsretirees covered by the group health planand all dependents of these employees or former employees  The notice simply certifies that the prescription drug plan offered by the group health plan qualifies as “creditable coverage” for the purposes of being equivalent with Medicare Part D.  Why does creditable coverage matter? The Medicare Modernization Act imposes a late enrollment penalty on individuals who do not maintain prescription drug coverage for 63 days or longer, following their initial date of Medicare eligibility. The notice serves to inform individuals that their group health plan does provide this coverage. Otherwise, if they are not maintaining coverage they should consider enrolling in Medicare Part D promptly, in order to avoid a penalty later.  How does Medicare know whether an individual has maintained creditable coverage? The law also requires employers to file an online disclosure to certify the creditable coverage status of their group health plan. This disclosure should be filed no later than 60 days from the beginning of the plan’s contract year, within 30 days of termination of a prescription drug plan, or within 30 days of any change to the status of creditable coverage.  Again, notices of creditable coverage must be sent to all affected employees and former employees by October 15. Medicare must also be notified of your plan’s creditable coverage status. Contact us with any questions regarding these notices, so that we can assist you in properly complying with the...

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Who could have predicted the changes 2020 has brought? Remote working, or working from home, was rising in popularity prior to this year. Even still, no one expected the swift and dramatic rise of remote work at the level we’re currently experiencing. Because this change has happened so suddenly, many businesses found themselves somewhat unprepared for the transition. Institute these safe practices, and pass them along to your employees to help things run more smoothly. Ensure that each device is protected. Employees should use a device dedicated to work; sharing with family members should be strongly discouraged. Remind them to install security updates when prompted, and to protect devices with passwords. Use safe WiFi connections. Working from home sometimes also means working from hotels, cafes, other locations. Remind your employees that public WiFi connections are not secure, and can put your data and business operations at risk. As for home WiFi, make sure everyone is using a strong password and secure firewall. Adopt a VPN. Institute a Virtual Private Network for company use, and make sure to update settings and limitations regularly. Consider two-factor authentication. Your cloud system and any other processes should be protected with two-factor authentication, for optimal protection against data theft or loss. Create a protocol guide. Update your old security protocol, or adopt a new guide, to clearly communicate your expectations to employees. Focus on the expected response in the event of device loss or theft, and for suspected or known security breaches. Each employee should know how to immediately proceed if one of these events occurs. The above procedures can help protect your business from unwanted virtual viruses and more… But what about real-world viruses and other health risks? Check with your healthcare plan administrator about telemedicine (virtual healthcare appointments). This type of healthcare is not only time-saving; receiving healthcare from home can shelter us all from the inherent risks of waiting rooms. If these benefits are available under your plan, communicate that information directly to employees. Review sick leave procedures and determine how you will handle telemedicine appointments as time away from “the office”. Working from home is still work, and together we can adopt procedures to keep each other safer at this...

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Telemedicine sounds like a new thing, but the origins of “remote” healthcare lie all the way back in the 1950s. Many decades ago, patients learned that they didn’t always need to visit their physician in person when a simple phone call would suffice. Today, telemedicine is supported by high-speed internet access, allowing us to attend face-to-face virtual “visits” with our healthcare providers. And in the time of Covid-19 and shelter-in-place orders, many insurance carriers are now covering telemedicine appointments. Telemedicine actually encompasses three areas of patient care: Interactive care allows patients and healthcare providers to “meet” virtually to discuss symptoms and other concerns Remote patient monitoring allows providers to collect data on patients remotely, such as blood sugar levels, blood pressure, and more Store and forward is a method of sharing a patient’s healthcare information with other providers and specialists (with the patient’s permission, of course) While telemedicine does include all of these areas of practice, most of us associate the term with virtual medical appointments conducted via video call. These interactive care appointments can benefit the patient in a number of ways, including: No need to travel to an appointment; the visit can be conducted from home or anywhere else the patient is located No worries about obtaining childcare or juggling schedules in order to attend appointments Fewer hours missed from work and/or school Limiting exposure to other illnesses in hospitals or medical offices Quicker access to care Affordability of care; telemedicine appointments are often priced much lower than in-office consultations Covered by many health insurance plans Reimbursed by Medicare and Medicaid/Medi-Cal in many situations Of course, telemedicine appointments should not be used for emergency situations. Patients should always call 911 or proceed to an emergency room if they suspect heart attack or stroke, have sustained a serious injury, or otherwise need immediate lifesaving care. But for routine care, minor illnesses and injuries, mental health treatment, and many other non-emergency situations, telemedicine provides safe and quality healthcare at greater convenience to the consumer. Even better, the monetary savings help us all by helping to lower the cost of healthcare. Ask your healthcare provider if they offer telemedicine appointments, and familiarize yourself with the process so that you know what to do next time you need healthcare...

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From school openings to job security, to personal budgets and safety, we all have plenty to worry about right now. Luckily, your health insurance premium might not be one of them. Many health insurance providers have announced that they will be offering a variety of solutions to help consumers make their regular health insurance premium payments.  The pandemic situation has created a curious combination of events in these past few months. Due to fears of coronavirus, and shutdowns in many areas, the numbers of elective procedures and office visits at this time have sharply declined. With consumers avoiding both doctor appointments and emergency rooms, healthcare providers have reported a 30 percent drop in inpatient care, a 25 percent drop in outpatient care, and a 35 percent drop in physician services.  Naturally, such an enormous drop in healthcare services has equalled a decline in health insurance claims. Many of the major health insurance providers will be extending that savings to their customers, which can be great news if you’re worried about making premium payments right now or in the near future.  Depending upon your carrier, you might be able to take advantage of these provisions: A credit for premiums paid in previous monthsA discount on upcoming premiums dueAn extended grace period for making premium paymentsSuspension of out-of-pocket charges on some healthcare services Look for a notice from your health insurance provider, or you can call them directly to discover what help they might be offering to their customers. Alternately, feel free to call us and we’ll assist you in locating answers.  This is all great news, but we do want to caution you about one potential problem: Considering that preventive care accounts for many of the healthcare services postponed at this time, some of those avoiding doctor visits might be at increased risk of chronic health problems in the future. Stay in touch with your doctor, and discuss with them alternate means of accessing care. They will advise you of which preventive tests or procedures are most important, considering your personal risk factors, and help you make a plan to catch up on preventive...

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Sticking Together During Rough Times

Sticking Together During Rough Times


Posted By on May 9, 2020

This month, we wanted to reach out to all of our business clients. How are you holding up during these challenging times? Is there anything we can do for you? Just a few reminders… Have you applied for the Paycheck Protection Program yet? Or, do you anticipate applying in the near future? Funded through the Small Business Association, the Paycheck Protection Program provides businesses with a loan to cover eight weeks’ worth of payroll and other expenses. The goal is to help your business remain viable during our current economic climate, and of course, to help your employees keep their own bills paid. You can obtain a loan in the amount of 2.5 times your average monthly expenses, or $10 million, whichever is less. If you follow guidelines correctly, 100 percent of your loan could be forgiven (you won’t have to pay it back) You can qualify for Paycheck Protection if your business employs 500 or fewer workers, and you can demonstrate that the coronavirus pandemic has negatively impacted you economically. As you might expect, numerous rules and regulations apply to both qualification for the program, and in order to have your loan forgiven. Since this is quite a chunk of change, you will want to follow those guidelines to the letter. You can also apply for an Economic Injury Disaster Loan, for up to $10,000. This loan can also be forgiven in certain situations. And yes, you can apply for both programs, but you cannot use money from both programs toward the same purpose. If you have questions about HR and Benefits during this ongoing situation, give us a call. We can help you identify solutions to the unique problems your business is facing. Remember, we’re here for you! Sticking together makes us all stronger – so let us know if you need help with anything at this...

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Employees might decline enrollment in their company’s small group health insurance policy for any number of reasons, but what happens if they later change their minds? Fortunately, the law does provide for a Special Enrollment Period under those circumstances. That’s good news, because under California law we all must enroll in a health insurance policy or face a penalty at tax time next year. That requirement began on January 1 of this year. For many reasons, a worker might change their mind after once declining coverage. In most cases, such as loss of coverage under another plan, or due to marriage or addition of a new child, they have 30 days to request enrollment in the small group plan. However, if the lost coverage was CHIP or Medi-Cal, a 60-day enrollment period will apply. Currently, anyone who previously denied coverage for any reason can now enroll in a healthcare plan. You do not need to experience a qualifying life event in order to take advantage of this opportunity. However, the time to enroll does differ from one carrier to the next, so we advise acting now in order to have access to as many options as possible. Coverage will be equivalent to other enrollees. Special enrollees in small group plans must be offered the same benefits as those who signed up during the original enrollment period. They cannot be charged more than those who enrolled when first eligible. Benefits cannot be denied on the basis of a preexisting condition. The Affordable Care Act protects potential enrollees from being denied healthcare coverage on the basis of a condition which was present prior to enrollment. Enrollees cannot be asked to complete a physical or submit a health history before joining the small group plan. A general questionnaire may be used, provided it does not request genetic information and is not used to deny, restrict, or delay benefits. A group health plan cannot charge an individual more than any other similarly situated individual, based on any health factor. Contact us to learn more about small group health coverage, and we can help you determine whether a Special Enrollment period applies to your...

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