Essential StaffCARE NOT Affected by HEALTHCARE REFORM RULING
Offering Voluntary Benefits Will Become More Important
The Essential StaffCARE (ESC) plans that were introduced and approved in 2010 as supplemental insurance, are specifically exempt from the PPACA healthcare regulations as stated in the bill. Essential StaffCARE will continue to be the largest provider of Health Insurance to temporary and contingent employees within the Staffing Industry.
Essential StaffCARE has taken this leading position by obtaining waivers for its pre-healthcare reform clients, and in 2010, developing a new generation of Limited Benefit Health Insurance plans that are exempt from the complications of healthcare reform. These new ESC plans were developed as a result of detailed analysis of rates, specific benefit utilization and claims experience from the largest block of insured temporary employees in the country.
Pre-healthcare reform ESC co-insurance groups have received waivers to 1/1/2014.
These groups will be migrated to the exempt Essential StaffCARE plans on or before 1/1/2014, in a seamless process that will improve coverage levels and keep rates the same. The new exempt ESC plans have been exclusively marketed since 2010 and include: no pre-existing condition limitations, no deductible, no co-pay, a new lower cost Value Plan option, new PPO network, real patient advocacy services and exciting new optional benefit elections.
Since September of 2010, ESC has implemented over 250 new staffing company clients with this new generation plan, with nearly 100 new staffing groups implementing since January 2012.
Essential StaffCARE continues to maintain the highest employee participation rates in the Staffing Industry. High employee participation in a voluntary benefit plan is the true measure of its success.
Since introducing the healthcare reform exempt ESC plans, Essential StaffCARE and its executives have been presented the two highest awards given by the National Association of Health Underwriters for “Outstanding Leadership in the Health Insurance Industry” and “Demonstrating Exceptional, Professional Knowledge and Outstanding Client Service”.
On 6/29/2012, the U.S. Supreme Court issued its long-awaited decision on cases challenging the Affordable Care Act. The highly anticipated ruling upheld the constitutionality of the law based on the taxation power of Congress.
Full-scale implementation of PPACA will continue unabated.
In addition to the PPACA ruling, the High Court modified the mandated expansion of Medicaid eligibility. This expansion is now voluntary. Each State can refuse to expand Medicaid without losing the federal funds for Medicaid that they currently receive. State budgetary realities make it less likely they will expand this costly entitlement program, even with the promise of receiving Federal subsidies for five years.
The Medicaid ruling is important to the Staffing Industry because it disrupts the concept that large numbers of temporary employees would now qualify for Medicaid and fewer employees would need access to an employer sponsored plan. These modifications to the Medicaid expansion mandate will reduce the anticipated increase of new Medicaid recipients, and reinforces the value of offering a Voluntary Limited Benefit Health Insurance Plan that provides temporary employees access to quality healthcare services with no deductible or co-pays.
With respect to businesses with 50 or more full time equivalent employees, The Supreme Court ruling results in the following:
Full-scale implementation of PPACA will continue unabated.
All insurance reform provisions will remain in effect.
Many of the hesitant states will move to build exchanges while some will continue to refuse compliance. Many states will have to engage in a partnership exchanges or a federally facilitated exchange, at least for the first few years, as they will not be able to put the required pieces together to open a state-run exchange by January 2014.
The premium subsidy for qualified people buying coverage through the exchanges will move forward uninhibited.
In 2012, Insurance Applications Group, LLC, commissioned a Health Care Issue Brief prepared by Milliman Actuarial Consultants. This analysis of Americans currently covered by major medical insurance illustrated 54% incurred medical claims less than $1,000 annually, and 30% incurred medical claims between $1,000 and $5,000 annually. The brief illustrated 84% of Americans incur less than $5,000 of medical claims annually. In comparison, the national actuarial study group reviewing State exchange viability estimates the lowest cost State exchange plan will have a $6,000 deductible for individuals and a $12,000 deductible for families.
(More than ever, temporary and contingent employees will need their staffing employers to offer an honest supplemental health plan with no deductible, no co-pay and no misleading illusionary benefits.)
With the exception of the limitation on the federal government’s authority to withhold Medicaid funding, all provisions of the PPACA stand. Compliance efforts likely will move ahead at full speed. In preparation for the major coverage expansion to occur under the PPACA in 2014, the Administration is expected to release a host of regulations dealing with the definition of minimum essential coverage, employer coverage and reporting requirements, and an array of new taxes and fees.
Go to the following link to see a document prepared by the National Association of Health Underwriters (NAHU) as a refresher to the schedule of changes and dates. The numbers of new taxes and fees to be implemented are especially noteworthy.
Essential StaffCARE will be conducting a series of Healthcare Ruling webinars on August 1st, 2nd and 3rd at 3:00 PM EST. Topics will include a refresher on the PPACA and Staffing Industry Specific Issues, including how to assess and avoid questionable and risky schemes or programs that could have a serious and possible regulatory impact on your business. For more information on our Healthcare Ruling webinar, go to: www.eschealthcarereform.com
Essential StaffCARE is an Insurance Applications Group, LLC (IAG) Health Insurance and Benefits solution. Essential StaffCARE specializes in the development of insurance products, benefit communication and administrative systems for the Staffing Industry. Essential StaffCARE is the largest provider of health insurance and benefit plans to the Staffing Industry, enrolling over 500,000 temporary employees each year. Essential StaffCARE is underwritten by BCS, a health insurance company majority owned by BlueCross BlueShield Plans, and is administered by Planned Administrators Inc., a wholly owned subsidiary of BlueCross BlueShield of SC, one of only two health insurance companies in the United States rated A+ (Superior) by AM Best & Co. This is the highest rating given to a health insurance company.
Valerie Hinton, Executive Assistant- Essential StaffCARE