Concerned About Losing Your Marketplace Plan? ACA Repeal May Take Awhile
Worried about your healthcare plan? Check out this interesting article from Kaiser Health News, by Michelle Andrews
President-elect Donald Trump has promised that he’ll ask Congress to repeal the Affordable Care Act on Day One of his administration. If you’re shopping for coverage on the health insurance marketplace, should you even bother signing up? If everything’s going to change shortly after your new coverage starts in January anyway, what’s the point?
While it’s impossible to know exactly what changes are coming to the individual market and how soon they’ll arrive, one thing is virtually certain: Nothing will happen immediately. Here are answers to questions you may have.
Q. How soon after Trump takes office could my marketplace coverage change?
It’s unlikely that much, if anything, will change in 2017.
“It’s a complex process to alter a law as complicated as the ACA,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. It seems unlikely that congressional Republicans could force through a repeal of the law since Democrats have enough votes to sustain a filibuster blocking that move. So Congress might opt to use a budget procedure, called “reconciliation,” that allows revenue-related changes, such as eliminating the premium tax credits, with simple majority votes. Yet even that process could take months.
And it wouldn’t address the other parts of the health law that reformed the insurance market, such as the prohibition on denying people coverage if they’re sick. How some of those provisions of the law will be affected is still quite unclear.
“It will likely be January 2019 before any new program would be completely in place,” said Robert Laszewski, a health care industry consultant and long-time critic of the law.
The current open enrollment period runs through January 2017. Shop for a plan, use it and don’t focus on what Congress may do several months from now, Rosenbaum advised.
Q. Will my subsidy end next year if the new administration repeals or changes the health law?
Probably not. Mike Pence, the vice president-elect, said on the campaign trail that any changes will allow time for consumers receiving premium subsidies to adjust.
Timothy Jost, an emeritus professor at Washington and Lee University School of Law in Virginia who is an expert on the health law, also predicts a reasonable transition period.
Congress and the new administration are “not eager to have a bunch of angry, uninsured voters,” Jost said.
Theoretical conversations about changing the health law are one thing, but “I think that Congress may be less willing to just wipe the subsidies out if a lot of people are using them,” Rosenbaum said. More than 9 million people receive subsidies on the marketplace, according to the federal Department of Health and Human Services.
Q. Can my insurer drop out once the new administration takes over, even if the law hasn’t been repealed?
No, insurers are generally locked in contractually for 2017, according to experts. But 2018 could be a whole different story, said Laszewski.
Many insurers are already losing money on their marketplace offerings. If they know that the health insurance marketplaces are being eliminated and replaced by something else in 2019, why would they stick with a sinking ship?
“The Trump administration could be left with a situation where Obamacare is still alive, the subsidies are still alive, but not the insurers,” said Laszewski. To prevent that, the Trump administration might have to subsidize insurers’ losses during a 2018 transition year, he said.
Q. My state expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level (about $16,000). Is that going to end if Obamacare is repealed?
It may. Trump has advocated giving block grants to finance the entire Medicaid program on the theory that it provides an incentive for states to make their programs more cost-effective. But that strategy could threaten the coverage of millions of Americans if the block grants don’t keep pace with costs, Jost said.
So far, 31 states and the District of Columbia have expanded Medicaid under the health law. Republican governors in these states may play a key role in arguing against taking the expansion money away, Rosenbaum said.
Q. I have a heart condition. Does this mean I’m going to have a hard time finding coverage?
It’s possible. The health law prohibits insurers from turning people away because they’re sick and may be expensive to insure.
Republicans have generally promised to maintain that guaranteed insurability, but what that would look like is unclear. Some of their plans would require people to remain continuously insured in order to maintain that guarantee, said Laszewski.
“I would advise people who are sick to get good coverage now and hang onto it,” said Jost.
Q. Since Republicans have pledged to repeal the law, can I ignore the law’s requirement that I have health insurance?
The individual mandate, as it’s called, is one of the least popular elements of Obamacare. As long as it’s the law, you should follow it, experts said.
Insurers have argued that the requirement that they take all comers who apply for health insurance only works if there’s a coverage mandate or other mechanism that strongly encourages people to have insurance. Otherwise why would they bother unless they were sick?
For the past few years, Republicans have been pushing hard to eliminate the mandate, Laszewski noted.
“One of the easy things they could do is just not enforce it,” he said.
See the original article Here.
Source:
Andrews, M. (2016 November 10). Concerned about losing your marketplace plan? ACA repeal may take awhile [Web blog post]. Retrieved from address https://khn.org/news/concerned-about-losing-your-marketplace-plan-aca-repeal-may-take-awhile/
New Workers Are at Highest Risk for Heat-Related Death
Did you know new employees or workers coming back from an extended break are at more risk of heat stroke? It is important to make sure these workers review safety procedures and gradually build up their tolerance to the heat. See the article by Dana Wilkie below and make sure your new workers are safe.
Original Post from SHRM.org
Who would you guess is most at risk for heat-related death while on the job?
It’s not necessarily older workers, first responders or those who toil outside all day.
Instead, the majority of recent heat-related deaths investigated by federal authorities involved workers who’d been on the job for three days or less.
That finding by the Occupational Safety and Health Administration (OSHA) highlights how important it is for employers to ensure that new workers—and returning employees who have been back to the job for a week or less—are prepared to protect themselves, OSHA authorities said.
With weather forecasters calling for above-average temperatures across much of the country this summer, the standard precautions—drink lots of water, take frequent breaks and spend time in the shade—may seem obvious. Yet those precautions may not be enough for new workers or employees returning to the job after extended time away. OSHA recommends allowing new or returning workers to gradually increase their workload and take more frequent breaks as they build up a tolerance for working in the heat.
Prevention
Construction workers make up about one-third of heat-related worker deaths, but employees who work outdoors across many industries—agriculture, landscaping, transportation, utilities, grounds maintenance, emergency response, and oil and gas operations—are at risk when temperatures go up. Additionally, indoor employees who do strenuous work or wear bulky, protective clothing and use heavy equipment are also at risk. High humidity increases the chances of heat-related maladies such as heat exhaustion or heat stroke.
In 2014, 2,630 workers suffered from heat illness, and 18 died from heat stroke and related causes on the job, according to OSHA.
Under the general duty clause of the Occupational Safety and Health Act, employers are responsible for protecting workers from hazards on the job, including extreme heat. To prevent heat-related illness and fatalities, OSHA offers these suggestions:
- Prepare a heat acclimatization plan and medical monitoring program. Closely supervise new employees, including those who are temporary workers or returning seasonal workers, for the first 14 days on the job—or until they acclimate to the heat. Though most heat-related worker deaths occur in the first three days on the job, more than one-third occur on the first day. If someone has not worked in hot weather for at least a week, his or her body needs time to adjust.
- Encourage workers to drink about one cup of water every 15-20 minutes, even if they say they’re not thirsty. During prolonged sweating lasting several hours, they should drink sports beverages containing electrolytes.
- Provide shaded or air-conditioned rest areas for cooling down, and encourage workers to use them.
- Provide workers with protective equipment and clothing, such as hats, light-colored clothing, water-cooled garments, air-cooled garments, ice-packet vests, wetted overgarments, and heat-reflective aprons or suits.
- Be familiar with heat illness signs and symptoms, and make sure employees are, too. Some heat exhaustion signs are dizziness, headache, cramps, sweaty skin, nausea and vomiting, weakness, and a fast heartbeat. Heat stroke symptoms include: red, hot, dry skin; convulsions; fainting; and confusion. In general, any time a worker has fainted or demonstrates confusion, this represents an emergency situation.
- Tell workers to notify a supervisor or to call 911 if they or their co-workers show signs of heat illness. Implement a buddy system where workers observe each other for early signs and symptoms of heat intolerance. Have someone stay with a worker who is suffering from the heat until help arrives.
- Encourage supervisors and workers to download OSHA’s Heat Safety Tool on their iPhone or Android device. [https://www.osha.gov/SLTC/heatillness/heat_index/heat_app.html] This app calculates the heat index, a measurement of how hot it is when taking humidity into account. The app also has recommendations for preventing heat illness based on the estimated risk level where one is working.
Dana Wilkie is an online editor/manager for SHRM.
Read original article here.
Wilkie, D. (2016, June 6). New workers are at highest risk for heat-related death [Web log post]. Retrived from https://www.shrm.org/ResourcesAndTools/hr-topics/employee-relations/Pages/New-Workers-Are-at-Highest-Risk-for-Heat-Related-Death.aspx
Just Say 'No' to Co-Workers' Halloween Candy
Originally posted on October 14, 2014 by Josh Cable on ehstoday.com.
Workplace leftovers might seem like one of the perks of the job. But when co-workers try to pawn off their Halloween candy on the rest of the department, it's more of a trick than a treat.
Those seemingly generous and thoughtful co-workers often are just trying to keep temptation out of their homes.
"Not only does candy play tricks on your waistline, but it also turns productive workers into zombies," says Emily Tuerk, M.D., adult internal medicine physician at the Loyola University Health System and assistant professor in the Department of Medicine at the Loyola University Chicago Stritch School of Medicine.
"A sugar high leads to a few minutes of initial alertness and provides a short burst of energy. But beware of the scary sugar crash. When the sugar high wears off, you'll feel tired, fatigued and hungry."
Tuerk offers a few tips to help you and others on your team avoid being haunted by leftover candy:
- Make a pact with your co-workers to not bring in leftover candy.
- Eat breakfast, so you don't come to work hungry.
- Bring in alternative healthy snacks, such as low-fat yogurt, small low-fat cheese sticks, carrot sticks or cucumber slices. Vegetables are a great healthy snack. You can't overdose on vegetables.
- Be festive without being unhealthy. Blackberries and cantaloupe are a fun way to celebrate with traditional orange and black fare without packing on the holiday pounds. Bring this to the office instead of candy as a creative and candy-free way to participate in the holiday fun.
- If you must bring in candy, put it in an out-of-the-way location. Don't put it in people's faces so they mindlessly eat it. An Eastern Illinois University study found that office workers ate an average of nine Hershey's Kisses per week when the candy was conveniently placed on top of the desk, but only six Kisses when placed in a desk drawer and three Kisses when placed 2 feet from the desk.
And if you decide to surrender to temptation and have a treat, limit yourself to a small, bite-size piece, Tuerk adds. Moderation is key.
Retention Starts Day One
Originally posted May 12, 2014 by Stephen Bruce (PhD, PHR) on https://hrdailyadvisor.blr.com.
Retention’s going to be key for many organizations as the economy improves—your best people are going to be testing the water and your toughest competitors are going to be looking for them.
There’s Nothing I Can Do
Many managers have the attitude “I wish management would do something about retention.” That’s the first thing to correct—it’s every manager’s and supervisor’s job to work on retention. They should realize that it’s for their own good. Turnover (of good people) is their department’s most debilitating disease.
First of all, it eats away at the manager’s personal productivity—job requisitions, postings, interviews, reference checks, and training suck up a lot of valuable time.
Second, turnover is a morale killer. Everyone else has to pitch in and get the job done while the position is vacant. And then there’s the inevitable, “Why are all our good people leaving? What do they know that I don’t know? Should I start putting together my résumé?”
Retention Starts Day One … and Continues Every Day
Managers and supervisors who have great retention rates share several behaviors: They think of their employees as customers; they recruit every day; and they remember that their actions are always on display.
Employees Are Customers
How far would you go to retain a good customer? Make sure you put that level of interest in retaining your employees.
- What do they care about?
- Do they understand their contribution and do you show that you value that contribution?
- What can you do today to make sure you retain them as a customer?
Recruit Every Day
As the saying goes, better recruit your best people every day … your competitors are. Try to avoid that oft-referenced situation where managers and supervisors spend 80 percent of their time on the poorest-performing 20% of their employees.
You Are on Display
Your actions speak louder than any policy or handbook declaration. “Our employees are our most valuable asset” sounds good on paper. Do you live up to that premise in your day to day dealings with employees?
You Have a Road Map
During the interviewing process, you found out about the new employee’s aspirations and expectations. And you probably made a few promises about the future as well. Together, those lists will help you build a retention road map for that employee.
Onboarding
Too many managers think that onboarding is something HR does with new employees the first day to get them signed up for benefits.
Onboarding is the first step in retention—get it right.
To be effective, onboarding is an involved process that lasts weeks or months. There are business methods and approaches to be learned, contacts to be made with key players in different departments, and various assimilation activities that help the new person be comfortable and contributing.
Remember that new employees are often reluctant to ask for help, so keep careful tabs on their work. Consider assigning a “buddy.”
A recent survey conducted by BambooHR shows the following often overlooked factors in an effective onboarding process:
- Receiving organized, relevant, and well-timed content
- On-the-job training
- Assignment of an employee “buddy” or mentor
- Having the onboarding process extend beyond the first week
When it comes to which aspects truly matter to employees starting a job, free food and perks are not what they crave. They want an onboarding process that helps them reduce the learning curve in becoming an effective, contributing team member.
Fast-rising medical ID theft hits employers hard
Originally posted May 22, 2014 by Alan Goforth on www.benefitspro.com.
About the last thing companies dealing with the complexities of implementing Obamacare need right now is to have the security of their employees’ medical information compromised. However, statistics show that is exactly what is happening.
“Medical identity theft is a rapidly spreading malady, often by organized-crime rings,” said James Quiggle, spokesman for the Coalition Against Insurance Fraud, a nonprofit alliance of carriers, consumer groups and government agencies in Washington, D.C. ”Data breaches in this era of digital record-keeping can drain businesses and make employee records as vulnerable as patients.”
More than 1.8 million Americans were victims of medical identity theft in 2013, a crime that is increasing at an annual rate of 32 percent. This makes it the fastest-growing type of identity theft, according to the Identity Theft Resource Center in San Diego.
Medical ID theft is already a multibillion-dollar industry. For the fiscal year ending Sept. 30, 2013, the federal government alone recovered a record $4.3 billion from people and companies that attempted to defraud health-care programs, according to the U.S. Department of Justice and the U.S. Department of Health and Human Services.
Stealing enough personal information to purchase services or devices is not difficult for a sophisticated identity thief, said Drew Smith, founder and CEO of Scottsdale, Ariz.-based InfoArmor (pictured at left). His company has provided B-to-B clients with protection against various types of ID theft since 2007.
“You can go online and readily purchase someone’s basic identity information for about $50,” he said. “You usually don’t need a lot of identification to receive medical care. Most identity thieves are not using it for primary care. It’s going for things such as medical devices, prescription drugs or other areas where there is less likely to be a personal relationship with the provider.”
Hidden employer costs
Statistics rarely account for the hidden cost of lost productivity when an employee has been victimized. Dealing with the fallout can be a painstaking, time-consuming process. The average medical identity theft loss is $22,346 – six times higher than financial identity theft. Also, on average, it takes victims more than a year to clear up medical records and repair any damage to their credit.
“Employees have to deal with identity theft issues immediately, which requires time off work and lost productivity, because some banks and agencies may be open only on work days,” Smith said. “Most medical ID thefts go undetected for a year. It’s not like credit card fraud, where you usually are notified quickly if someone tries to use a stolen card. Because of the way medical records are stored, they are extremely fragmented and hard to fix when you find out. That’s why reducing the risk of medical identification theft can help a business’s bottom line.”
Employers may be surprised to learn that medical identity theft may be as likely to occur from within their organization as from outside.
“Fifty percent of medical ID claims are considered `friendly fraud’,” Smith said. “For example, an employee’s brother may be out of work and they allow him to use their insurance card, or a family member borrows it without permission.”
Best defenses
Although eliminating medical ID theft may be impossible, businesses do have effective options to significantly reduce risks and quickly detect breaches. “Managers must implant internal controls and train employees to harden their protection of personal data,” Quiggle said. “Protocols to protect against insider theft are especially important.”
One of the most successful defenses costs nothing to implement.
“The No. 1 thing to emphasize with employees is to be smart about their user names and passwords,” Smith said. “Many people use the same ones for multiple sites, such as health care, banking and payroll information. Identity thieves are pretty adept at stealing credentials and often use them to steal from more than one account.”
Early notification of security breaches also is critical. “Timeliness is key,” he said. “Most explanations of insurance benefits don’t come for 30 to 90 days, but we can provide real-time alerts.”
Companies such as InfoArmor can provide several levels of protection. “The entry level (service) is monitoring personal and insurance carrier information,” Smith said. “We can alert employees daily to a potential compromise of their information online.”
The next level is to search the Internet and other networks for employees’ potentially exposed medical information that may be bought or sold. InfoArmor’s service providers also evaluate medical professionals who submit claims.
“We are able to do scoring behind the scenes to identify doctors with a record of fraudulent claims who may present a high risk,” Smith said. “Finding these fraudulent doctors often is like looking for a needle in a haystack, but we can help make the haystack much smaller.”
InfoArmor is testing a new service that it calls ID Verification, which uses information from dozens of public record databases to enable providers to confirm a patient’s identity before services are administered.
“The newest services are the most employee-focused,” Smith said. “We can determine which employees have a greater inherent risk and monitor their claims data daily. We look for certain flags, such as care being received farther from home, durable medical equipment being purchased in their name or a high volume of paperwork over a short period of time. We then can issue an alert. And we are careful to do everything in a HIPPA-compliant manner.”
Smith said it is still too early to judge the potential impact of the Patient Protection and Affordable Care Act (PPACA) on the incidence of medical identity theft. But for employers seeking ways to reduce medical identity theft and its repercussions on employees, the best offense is a good defense.
“Don’t believe people who try to tell you they can prevent identity theft, because they probably are lying,” he said. “Because theft is not going away, the solution is to detect digital crimes faster.”