We Remenber

Grand-fathering Update

November 16, 2010, the federal government published an amendment to the original “grandfather” regulations that were published last June concerning how employers can maintain grandfathered health plan status.
The new amendment “allows all group health plans to switch insurance companies and shop for the same coverage at a lower cost while maintaining their grandfathered status, so long as the structure of the coverage doesn’t violate one of the other rules for maintaining grandfathered plan status.”


The updated announcement is posted on the U.S. Department of Health and Human Services website, click here to view that announcment. This amendment is scheduled to be published tomorrow, November 17, in the Federal Register.



The HHS website states further:



“The purpose of the grandfather regulation is to help people keep

existing health plans that are working for them. This amendment furthers

that goal by allowing employers to offer the same level of coverage through

a new issuer and remain grandfathered, as long as the change in issuer does

not result in significant cost increases, a reduction in benefits, or other

changes described in the original grandfather rule.”



HHS notes that “the original regulation only allowed self-funded plans to change third-party administrators without necessarily losing their grandfathered plan status.” The revised regulation impacts “insured group health plans” but not the “individual market.” HHS elaborates that “(u)nder this amendment, all employers have the flexibility to keep their grandfathered plan but change insurance company or third-party administrator.” The regulation was motivated in part to allow employers to shop around for better-priced insurance.

Ten Thoughts On Hiring A Benefits Broker

Engaging a broker to assist you with solving your benefits issues be they cost, communications, enrollment or problem solving with existing vendors can be a difficult task for business owners and professionals faced with the task. Here are some critical considerations to assist you in that task.

1. Do you desire a transaction or a relationship with your broker rooted in performance over time?
2. Do you want to work with someone who sells to you or someone who problem solves on your behalf? Its easy to separate the salesman barraging you with requests to quote your business its far more difficult to find the professional who proactively proposes solutions to your problems after asking a lot of questions. Professionals do not quote your business they are engaged upon being hired as they simply do not need the practice.
3. Google is your friend.Google the brokers name. What does it tell you about that individual? Are they published? What is their background professionally? Do they offer valuable professional insights and opinion on the pressing matters of the day like health care reform?
4. Are they independent? By that I mean do they represent multiple insurance companies?
5. What is the brokers business model?  Are they focused on revenue generation or the service of existing customers?Will you as the business owner or benefits owner deal with someone who is an experienced professional or will you deal primarily with an account manager or service prepresentative who works for the broker? If the latter why not just hire your own clerk? Who you deal with routinely is a good insight into the business model a broker utilizes.
6. Does the broker specialize in benefits? Property & Casualty and Employee benefits are fundamentally different businesses with different markets and completely different risk dynamics. Dealing with the benefits department at a P&C shop is like buying fine wine at a convenience store; you may geta bottle but you may not savor the experience. People who are experts at everything tend to lie about other stuff too.
7. Can the broker interface effectively and educate and train your staff to effectively manage benefits through vendors or will you have to go through the broker for every trivial issue? The best brokers align competent vendors who can deliver for their clients based on clearly defined expectations and get involved quickly when the vendor stumbles. In the era of HIPAA relying on your broker to solve every issue is a recipe for delay and frustration but some brokers like to control their clients in this manner always blaming the carriers.
8. Who called whom? In other words are you giving a shot to someone who has been begging you for years to quote your business or are you contacting a broker whom you were referred to by someone whose opinion you respect? Think about this carefully.
9. Do you really want to deal with an employee about employee benefits? In other words as a business owner or the principal  at your firm charged with handling employee benefits do you want to deal with someone who receives a paycheck for doing a job or someone whose compensation is based on performance and your ultimate satisfaction? In America the best professionals work for themselves because they can its really that simple.
10. Bigger is not necessarily better. You want someone you would easily refer to a family member or best friend needing assistance with employee benefits. If you do not feel this way about your broker it may be time to shop for a new broker.

Thanks To All Veterans

Thanks to all the veterans out there as well as those presently serving. Took my Dad to lunch today. He is a US Navy Veteran who served from 1951-1955 as a corpman on the USS Johnson a destroyer. About half Dad's class in corpman school wound up serving with the Marines in Korea. Many of them never made it home.

10 Reasons For Tuesdays Election results

Yes, the tidal wave that elected a Republican US Congress along with numerous state houses, senates and governors was due to the economy Mr President but it was also due to the failures systemic within HealthCare Reform.

1. As Rasumssen polls on the evening of the election 59% of those who voted in the election favor a repeal of your beloved PPACA.
2. Sixty-three percent (63%) of those who voted today are at least somewhat angry at the current policies of the federal government. That includes 42% who are Very Angry.
3. Look at the US Map for a graphical representation of election  results here.
4. You said HCR was essential but it raises the deficit.
5. You said no pre-existing conditions for children but try to find a carrier who will write a child only policy in the individual market.
6. There is no longer a market for salaried only carveouts on a group basis thanks to PPACA.
7. Obama said people could keep their Doctor but seniors under Medicare advantage plans will not because those plans are toast raising costs for fixed income retirees.
8. Obama said PPACA would lower costs for employers but trends show the mandates of PPACA are accelerating cost increases for employers.
9. Those employers faced with Massive increases no longer have the catstrophic options which might have made keeping a health plan possible thanks to PPACA.
10. Everybody but President Obama seems to understand there is no way in hell those exchanges will be up and running by 2014.

The mid-terms were a referendum on President Obama and the policies of an arrogant Congress led by Harry Reid and Nancy Pelosi who shoved an idiotic stimulus bill, a Health Care "Reform" bill, a financial services reform bill. Thank God you failed on Immigration reform and cap & Tax.

The mid-terms were a complete and utter rejection to Progressive Wonkery.

Vote!