federal laws — Benefit Solutions By Design

Deadline Looms For DOJ Appeal Of Healthcare Ruling

September 25, 2011 By Tamela Southan Leave a Comment

Politico (9/23, Haberkorn, 25K) reports, “The Obama administration has to decide by Monday whether it wants to directly ask the Supreme Court to review the constitutionality of its signature health reform legislation.” Since a three-judge panel of the 11th Circuit Court of Appeals “ruled against the health law in August, the administration can either ask the full court to take another look at the case or ask the Supreme Court to review it and issue a final decision.” Politico notes that the Justice Department “has until Monday to file paperwork if it wants to go back to the full circuit court,” and if the department does not file or get an extension, it has no other option than to ask the Supreme Court to rule on the 11th Circuit’s decision. http://www.politico.com/news/stories/0911/64140.html

Industry Seeks Savings from Medicare Beneficiaries

September 21, 2011 By Tamela Southan Leave a Comment

Members of the Healthcare Leadership Council—which includes top executives from Pfizer Inc., Aetna Inc. and the Mayo Clinic-are expected to approve a proposal that would call for raising Medicare’s eligibility age and shifting the program toward private plans for beneficiaries. The group plans to press members of the congressional “supercommittee,” charged with finding $1.2 trillion in budget savings, to include the changes in its broader cost-cutting plan.

The council’s proposal is part of a larger effort inside the health industry to overhaul how lawmakers achieve savings from federal health programs. For years, Congress largely has relied on slicing payments to doctors and hospitals that treat Medicare beneficiaries to shrink spending in the program that insures 48 million elderly and disabled Americans.

Frustrated at being the target, the health industry is pushing back, arguing that some of those savings should come directly from the pockets of Medicare beneficiaries.

“This thinking that we’re protecting beneficiaries because we’re only cutting providers—that’s mythical,” said Mary Grealy, the council’s president. “At some point it does affect beneficiaries,” she said, because such cuts weaken health-care providers’ ability to offer services.

There’s growing pressure in Washington to rein in the major health-care entitlement programs—Medicare and Medicaid—as lawmakers struggle to cut the federal budget deficit.

Adamy, Janet,

Industry Seeks Savings from Medicare beneficiaries, The Wall Street Journal – Print and Online September 13, 2011

Filed Under: Health Care Reform, Medicare, federal laws

Check Out Consumerism, Cost Saving $$$

June 14, 2011 By Tamela Southan Leave a Comment

Knowledge is Power

All healthcare accounts are not created equal. That’s why you need an experienced, trusted advisor to help you when it comes to your healthcare finances. Benefit Solutions by Design is here to help youunderstand the sometimes complex and confusing world of healthcare account acronyms (HSA, HRA, FSA, MSA, Oh my…). Are you a Smart Healthc Care Consumer?

Consumer-driven health plans are the latest response to soaring costs. They teach and empower consumers to take financial control of their health care spending; Health Savings Accounts (HSAs) are the centerpiece of this new approach.

With the HSA/HDHP, consumers have significant power and responsibility for their health care decisions. The consumer (or the employer, or both) sets aside a pool of money to spend on health care before HDHP coverage kicks in. Policymakers hope that, by having such a financial incentive, participants will become better and more prudent health care consumers; healthcare nest egg or smart spender.

Filed Under: Affiliations, Dental, Dependents, Employee Interest, Events, Health Care Reform, Health Plans, High deductibles, IRS, Low cost, Medical plans, No Copays, PPO - Preferred Provider Organization, Partners, Pharmacy, Pre-X, Recognition, Roll over funds, Savings, Section 125 of IRS Code, Small Business, Smarter Consumer, Smarter Consumer, Tax Savings, You own the funds, compliance, continuation of benefits, coverage, federal laws, state laws

Texas Quietly Planning For Health Insurance Exchange

June 14, 2011 By Tamela Southan Leave a Comment

Texas State Capitol

The New York Times /Texas Tribune (6/10, A19A, Ramshaw, Subscription Publication) reports that despite Texas Gov. Rick Perry’s (R) “stated opposition to a federally-mandated health insurance exchange and the state’s participation in lawsuits aimed at overturning federal health reform, officials at the Texas Department of Insurance acknowledge that since last fall, with the help of a $1 million grant from the United States Department of Health and Human Services, they have been working quietly to plan for a health insurance exchange.” The article quotes John Greeley, a spokesman for the Texas Department of Insurance, as saying, “We’ve been going full speed ahead on implementation, doing the due diligence so that we can be on time with what the law says.” Meanwhile, “Lucy Nashed, a spokeswoman for Mr. Perry, said the governor is aware of the grant, which she said is exploratory and does not require Texas to set up an exchange.” http://mailview.custombriefings.com/mailview.aspx?m=2011061001nahu&r=4958615-5c23

Filed Under: Affiliations, Dependents, Employee Interest, Events, Health Care Reform, Health Plans, High deductibles, Low cost, Medical plans, Partners, Pharmacy, Pre-X, Recognition, Savings, Small Business, Smarter Consumer, Smarter Consumer, Tax Savings, compliance, continuation of benefits, coverage, federal laws, state laws

Lower Cost Higher Deductible Tax Saving Plans

June 13, 2011 By Tamela Southan Leave a Comment

It's Yours or Uncle Sam's?

ALPHA BET Soup of Health Care

Managing your healthcare dollars, including choosing the right provider, the right care, at the right time, for the right price is more complicated – and potentially much more important – than managing your retirement accounts. But where is the budding industry of healthcare financial advisors to help people better make these critical decisions? (Benefit Solutions by Design)

Consumer-driven healthcare will fail unless consumers are educated, empowered and supported with the knowledge they need to make good decisions. Just like during the rise of 401Ks and IRAs, there is a need for a higher, not a lower level of service, that was provided in the old world. Without the mission critical healthcare financial services, CDH will not create careful consumers that decrease spending, but may be, as the critics claim, just another cost shift. What are you? A super spender or super saver? This is a solution for you if your open to change and becoming a smarter consumer than those addicted to the copay.

Filed Under: Dental, Dependents, Employee Interest, Events, HSA - Health Savings Account, Health Care Reform, Health Plans, High deductibles, IRS, Low cost, Medical plans, No Copays, Partners, Pharmacy, Pre-X, Roll over funds, Savings, Section 125 of IRS Code, Small Business, Smarter Consumer, Smarter Consumer, Tax Savings, You own the funds, compliance, coverage, federal laws, state laws Tagged With: health premiums federal government enroll reduce easy reduced cost, http://www.youtube.com/watch?v=H4mpct4hRSs, Money

COBRA? State Continuation? What to do!

June 13, 2011 By Tamela Southan Leave a Comment

What is it and How Does it Work?

: Checked Your Compliance List Lately?

Confused about what compliance rules apply when an employee terminates employment triggering a loss of their benefits. What are your obligations as an employer to keep in compliance with the state / federal regulations in offering the terminated employee & their covered dependents continuation rights. Rules and regulations, who is responsible, what are the requirements and time lines? Great questions that I can help you resolve. Since groups subject to Texas State Continuation (TSC) are almost 100% fully insured groups, “the employer or the group policyholder” are one and the same! Required to provide the terminated members their right to continuation of group coverage. As an industry professional, your hiring me to provide solutions driven support to meet these compliance needs. Let’s close your compliance gaps.

Filed Under: 9 months, Affiliations, Dependents, Employee Interest, HMO - Health Maintenance Organization, HSA - Health Savings Account, Health Care Reform, Health Plans, Medical plans, PPO - Preferred Provider Organization, Pre-X, Small Business, compliance, continuation of benefits, coverage, federal laws, state laws Tagged With: health premiums federal government enroll reduce easy reduced cost, Money, pre existing

Deadline Looms For DOJ Appeal Of Healthcare Ruling

Industry Seeks Savings from Medicare Beneficiaries

Check Out Consumerism, Cost Saving $$$

Texas Quietly Planning For Health Insurance Exchange

Lower Cost Higher Deductible Tax Saving Plans

COBRA? State Continuation? What to do!

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