The Kaiser Family Foundation/Health News discusses the new site coming from the Health and Human Services department.

Not that I don’t have faith in the HHS to put together an informative, easy-to-use site that will encompass every public and private option available to residents living in 50 states, each with their own specific health insurance laws….

… but for now, I can guarantee that consumers are far better off referring to the excellent Foundation for Health Coverage Education, a comprehensive resource produced by industry experts.  There is a simple online quiz that you can take which will help individuals and families figure out what public and private options are available to them.

More than eighty percent of my small business clients offer an HSA-compatible health plan as an option to their employees. Some of them partially fund accounts for the employees to help offset the high deductibles, and still find that this is the most cost-efficient way to finance employee health care.

Ditto for individuals and families. It is particularly pleasing to help a family paying $1,000 – $1,500/month on COBRA or a small business plan realize that they could save $10,000/ year in premiums by switching the family to an HSA-compatible plan from their choice of carriers.

More on this trend, from the Kaiser Family Foundation, here.

A client forwarded me this trailer, and I am eager to see the hour-long documentary on Sunday (thanks, Allan).

An ambulance gets turned away by an overcrowded ER every minute in the U.S.

22,000 deaths per year can be attributed to not having health insurance. Which makes it the 6th leading cause of death, ahead of HIV/AIDS and diabetes.

82% of the LA Fire Dept calls are for medical services, rather than fires. The documentary follows LAFD Station 65, located in South LA, and the challenge of strained resources and a broken system.

On March 23, 2010, President Obama signed into law H.R. 3590, the Patient Protection and Affordable Care Act (PPACA).

This piece of legislation is 2,500 pages long, and all of its details are still being sorted out.  Allpointe will stay on top of the changes, and provide you with periodic updates.  If you have questions at any time, please contact us.

Many pieces of the legislation will not kick in until 2014; however, a number of changes will take place in 2010 and 2011, directly affecting small business health plans.  One immediate change that should be of interest to every small business owner: tax credits for the funds you currently spend on health insurance for your employees.

Yes, there are restrictions which may quickly eliminate many Bay Area employers (average employee wage must be under $50,000/year).  But it is definitely worth checking out.  The IRS has just provided details on the tax credit and eligibility guidelines.  If you think you may qualify, we can assist you with this by directing you to tax and legal professionals who are familiar with the credit.

Some other changes that will affect small employers in the next 6-12 months:

• Dependent children must be covered up to age 26 (no requirement for full-time student status)
• Waiting periods for new hires may not be longer than 90 days
• Employers must enroll employees (with an opt-out provision) in the new federal Long Term Care benefit
• Over the counter medications will no longer be a qualified expenses for HSA/FSA/MSA accounts, unless prescribed by a physician
• The penalty for unqualified withdrawals from a Health Savings Account (HSA) will increase from 10% to 20%

For a full summary on the implementation timeline, Employee Benefit News has a two-part summary on their web site.  You can also download a good, detailed overview from the National Association of Health Underwriters.

Again, we will continue to keep you updated as additional guidelines come out, and will review these in detail with you as your small business health plan approaches its upcoming renewal.

Employee Benefit News has an excellent summary of the extension and modifications of the COBRA subsidy program.

Even if you are not an Anthem Blue Cross subscriber, it would be hard not to have heard about the recently announced rate hike for many California subscribers.  If not, you can read about it here (LA Times, 2/14), here (SF Chronicle, 2/14), and here (NY Times, 2/16).

For additional perspective, here is the full letter of explanation written by Brian Sassi of Anthem Blue Cross in response to Health and Human Services Secretary Kathleen Sebelius’s inquiry into the rate increases.

A couple of key points, without getting into the meat of the debate:

• The rate increases are affecting Anthem Blue Cross individual subscribers, not small business subscribers
• Anthem has delayed the increases for two months (to May 1) while the issue is investigated

We understand that a number of our individual clients may be experiencing an increase in rates — and not necessarily just from Anthem.  Please remember that we are always here to assist you.  Contact our office via email or call (888) 992-2244 to schedule an an appointment to discuss whether a different plan or a different carrier is the right choice for you.

The most recent iteration of the current jobs bill being considered by the Senate has stripped out a second extension of the 65% COBRA subsidy for certain laid-off workers, according to the Christian Science Monitor (2/11).

With Congress back in session this week, we should get an idea of whether the subsidy will be added back in, considered in a different bill, or allowed to expire on March 1.

California workers at smaller companies who qualify for Cal-Cobra, not COBRA, may also eligible for the subsidy if they are involuntarily terminated before March 1.  You can find detailed information from the Department of Managed Healthcare.

Find out everything you need at the San Francisco OLSE web site

Summary of updates from Joannie Chang on 2/12/2010:

Newly Revised Documents
The Annual Reporting Form (ARF) for 2009 has been uploaded to our website
as a fillable PDF; to download this document, please use the link provided
in the section titled “Forms & Documents.”   Pre-printed ARFs will also be
mailed in March.   If you would like to check your mailing address, please
call Taxpayer Assistance at 415-554-4400.  Completed ARFs must be returned
by Friday, April 30, 2010.  (posted 2//12/10)

The Employee Voluntary Waiver Form has been reformatted to use a larger
font size and to fit on 8.5″x11″ paper.   There is no need to replace any
waivers you have on file, but the new form should be used for all future
waivers/revocations.  Remember that waivers are valid for only one year
after the date of signature.  (posted 10/13/09)

The FAQs have been revised to clarify questions regarding FAQs #16, 23, 26,
32, 39, 40, & 47.  (revisions posted 12/18/09 & 2/5/10)

The ESR Calculator has been revised to include 2010 expenditure rates.
(posted 1/20/10)

The Employer Notice regarding the Health Care Security Ordinance has been
revised to include 2010 rates.  (revised 1/28/10, posted 2/5/10)

Upcoming Presentations on the HCSO

None scheduled at this time.

Joannie C. Chang, Contract Compliance Officer
Office of Labor Standards Enforcement
www.sfgov.org/olse/hcso

* * * If you haven’t already, please visit our website, at
www.sfgov.org/olse/hcso, to review our Frequently Asked Questions document,
Final Regulations, the Ordinance,and other helpful information. * * *

Scott Hauge and Small Business California have been tireless advocates for California small businesses over the past few years.  Their agenda is your agenda.  That is, if you participate by completing their annual survey.

SBC is a non-partisan group.  I am involved in several other small business advocacy organizations, and I find SBC to be the most flexible, open and solution-oriented of the bunch.  They will listen to your story, and help you with your problem.  I encourage you to check out their web site.

Rather than add to the thousands upon thousands of words already written about how and why Scott Brown defeated Martha Coakley in last night’s Massachusetts special election (personally, I think it was the Schilling gaffe that sunk her), I want to spend a couple of minutes on two key elements of reform that few people seem to disagree with: people with pre-existing conditions and people who truly can’t afford to pay should not be denied access to health insurance and health care.

I often hear people in my industry (yes, that’s the health insurance industry) break down the numbers of the uninsured into three roughly equal groups of about 15 million each.  From what I have read, the numbers seem about right:

• 1/3 – Uninsured by choice.  This group is made up of “young invincibles” (e.g., recent college grads); healthy middle-class individuals who choose not to buy insurance; and people in transition from one employer-based coverage to the next (ask me sometime about how to maintain your COBRA rights for four months without actually paying premiums).
• 1/3 – Uninsured and unable to obtain coverage.  This is the group that would have been most helped by the reform legislation.  These are people who want to buy health insurance, but have pre-existing conditions which prevent them from being approved.
• 1/3 – Eligible for coverage and/or financial subsidies, but don’t know about it.  This group doesn’t get a lot of press, but considering the patchwork of federal and state insurance laws and programs, confusion and lack of information is certainly understandable.

As an independent health insurance broker, I spend most of my time with the first two groups.  I try to convince the first group that some type of catastrophic coverage — including HSA-compatible plans — are essential, in the event of the unexpected illness or injury.

The second group is the most challenging, but also the most rewarding for me (not necessarily financially).  This group benefits tremendously from information and resources.  We will go through everything — reapplying to alternate carriers, considering short-term plans, looking at COBRA, Cal-Cobra, HIPAA, and other guarantee-issue options, including a small group plan with as few as one or two people enrolled.

The third third doesn’t always find their way to me.  But when they do (and if you know anyone in this group), I will often refer them to the Foundation for Health Coverage Education.  This is a phenomenal resource, with multilingual support throughout the U.S. via web and phone.  People can use the online quiz, or refer to the Health Care Options Matrix to find out if they (or their dependent children) qualify for any one of the multitude of federal and state health coverage resources.

While we all await the eventual fate of the health care reform bill, why not see if you can help reduce the size of that third group?  If you know someone who may not be able to afford coverage, refer them to the FHCE.  The resource is free, and they might discover that they qualify for a low- or no-cost health coverage option.