ACS Welcomes Brooks Powell

2012 - 02

ACS Benefit services, Inc., welcomes G. Brooks Powell, III as a Senior Sales Consultant. His responsibilities include TPA sales and business development. Brooks began his professional career in 2001 at Gateway Health Alliance where he served as the Director of Marketing and Sales. He then worked for J. Smith Lanier Administrators as the Regional Brokerage Manager.  In 2008 Brooks was promoted to Business Development Officer of Wells Fargo TPA and was responsible for TPA sales for the eastern half of the United States. In 2010 Brooks was promoted to Vice-president of Sales for Wells Fargo Health Solutions. Brooks holds a B.S. in Business Administration from Averett University in Danville, VA. 

Ben Yeager, President of ACS, says: “We are very excited to have Brooks join ACS Benefit Services. His past experience will assist ACS in making great strides in expanding our self funded medical business in the region. Brooks is well respected in our industry and brings an abundance of knowledge in plan administration, risk management, wellness programs and managed care to our customers.”

Medicare Part D Annual Notices Deadline Changed to Oct. 15

2011-10

Employers who sponsor health plans that provide prescription drug coverage must provide an annual notice to Medicare-eligible participants describing whether their plan's prescription drug coverage is considered "creditable."   The notice must be given to participants annually before the beginning of the Medicare enrollment period.  The Patient Protection and Affordable Care Act changed the beginning date of the Medicare Part D enrollment period from November 15 to Oct. 15, beginning with the 2011 enrollment period.  A plan's prescription drug coverage is considered creditable if it is expected to pay as much as the standard Medicare prescription drug program. 

This notice is important because Medicare-eligible individuals who fail to enroll in Medicare Part D prescription drug coverage and who do not maintain creditable coverage for at least 63 days will become subject to a late enrollment penalty when they enroll in Medicare Part D coverage. 

This reminder is important because in the past year, plan sponsors distributed the annual notice of creditable or non-creditable coverage by Nov. 15.  This year it is due one month earlier, on Oct. 15.  Plan sponsors have the responsibility to update their notices of creditable or non-creditable coverage to indicate the new enrollment period and to distribute the notices by the deadline, Oct. 15.

Proposed Rules for Summary of Benefits and Coverage

2011-09

The Patient Protection and Affordable Care Act (ACA), passed in March 2010, required the Department of Labor, the Department of Health and Human Services and the Internal Revenue Service (collectively, "the agencies") to issue regulations describing the "Summary of Benefits and Coverage" that ACA created.  In Late August 2011 the agencies issued proposed rules for the Summary and for a uniform glossary of terms.  These are proposed rules (as opposed to interim or final rules) and the agencies have allowed until October 21, 2011 for comments on the proposed rules before making them final.  Thus, it is possible that some parts might change.
 
ACA requires all group and individual health plans and insurance policies to use the Summary of Benefits and Coverage form and the uniform glossary to describe the benefits in a way that may be understood by consumers who are or are considering being covered by a health plan.  The idea is to give consumers an "apples to apples" comparison of different plans.
 
The proposed rules lay out very specific length, appearance and format instructions and specify when and to whom the Summary must be given.  It also requires plans to change and redistribute the Summary at least 60 days before the effective date of any material change to benefits that are included in the Summary.  
 
The deadline for generating the Summary, according to ACA, is March 23, 2012.  Since that is only six months away, the final rules might delay that effective date or allow a phase-in period.  To view the proposed rules click the link below.
 
When the comment period is over and the rules are finalized, ACS will post more details on the new requirements.

http://www.dol.gov/ebsa/healthreform/index.html#2715

Plan Administrator's Alert #59

2011-09 Revised Rules About Required Preventive Care

You may have heard on the news or in your mail lately that health plans will now be required to cover contraception. Some of what we have heard is a little confusing and at times, contradictory, so this is a summary of what it means and how it applies to you.

One of the provisions of PPACA (the Patient Protection and Affordable Care Act) that was passed in March 2010 was that plans would be required to cover certain preventive services without cost sharing by the member. In the original interim regulations, the HHS (Department of Health and Human Services) directed the HRSA (Health Resources and Services Administration) to issue guidelines on preventive care specific to women’s health issues. The HRSA released those guidelines on August 1, 2011. A copy of the guidelines that were released on the HHS website (that we changed slightly to make more readable) is attached to this Alert. The guide explains the new covered services pretty well.

Since the new preventive services were adopted on August 1, 2011, all non-grandfathered plans must start covering these services with no member cost sharing for in-network providers no later than in the plan year that begins on or after August 1, 2012. For the vast majority of our self-funded health plan clients, that means the next time the plan renews its administrative services agreement on or after August 1, 2012. All plans may choose to cover these services before that date, rather than wait, if that makes financial and/or administrative sense.

The HRSA also included an exception to the required coverage for contraception for church plans. The applicable definition of a church plan is included in the footnote under the chart in the attached guidelines. Church plans will still be required to cover other preventive services.

If you have any question about this latest development in health care news, please feel free to call your ACS consultant, Lisa Scalzo, at extension 1003; Rich Harper at extension 1701, or Doug Lemmerman at extension 1100.