The Health Insurance Blog of Attorney Adam V. Russo
Welcome to Passion for Subro! The purpose of this site is to share my passion for the health insurance industry with the rest of you fanatics. I hope this site will be your destination for the latest in health care as well as self insured news across the country. While I envision that this site will serve as a great educational resource, it will also keep you entertained with the funny, difficult, confusing and just plain weird world of self insurance.
Thanks for visiting!
Posted By cmonfils on January 25, 2012
DOVER — “If you do something to encourage a healthy lifestyle, it will make folks happier, they’ll have more energy and be more productive,” says Pat Sliva at the Tuscarawas County Board of Developmental Disabilities.
Sliva is human resources coordinator at the Board and credits these positive outcomes to the organization’s five-year involvement with Union Hospital’s Workplace Wellness program.
Posted By cmonfils on January 25, 2012
The 2011 Society for Human Resource Management (SHRM) Health Care Benchmarking Survey examined health care costs for U.S. employees and found that costs vary widely, depending on the industry. One way to try to streamline health care costs is to opt for a self-funded health plan.
Some of the industries that the survey found “spent the most on health care per covered employee during plan year 2010″ were: Utilities; Insurance; Real Estate; Government; and Manufacturing. The industries that spent the least were: Telecommunications; Publishing; Broadcasting and other Media; Accommodation and Food Services; Arts, Entertainment and Recreation; and Business Support Services.
Posted By cmonfils on January 25, 2012
The Eleventh Circuit Court of Appeals recently held in a case of first impression in this circuit that the Family and Medical Leave Act (FMLA) “protects a pre-eligibility request for post-eligibility leave.” That is, the FMLA protects an employee who gives notice, before she is eligible for leave, of intent to take FMLA leave for a qualifying reason once she becomes eligible. Pereda v. Brookdale Senior Living Communities, Inc., D.C. Docket No. 0:10-cv-60773-FAM, Eleventh Circuit Court of Appeals (January 10, 2012).
Posted By cmonfils on January 25, 2012
This study examined the consequences of adding a fitness-membership benefit on the self-reported health status of enrollees in Medicare Advantage plans. Using a quasi-experimental design, we found that persons enrolling in plans after the addition of a fitness-membership benefit reported significantly better general health, fewer limitations in moderate activities, less difficulty walking, and higher PCS scores than did persons who enrolled in the same plan before the fitness benefit was added and in matched control plans that never offered a fitness benefit. These patterns persisted in the analyses of 2-year follow-up responses for all measures except self-reported general health. Our findings suggest that there is an association between the adoption of fitness-membership benefits in Medicare Advantage plans and the enrollment of healthier Medicare beneficiaries.
Posted By cmonfils on January 25, 2012
Insurance coverage can be a confusing thing. Coverage for employee benefit plan fiduciaries sometimes adds a wrinkle to the process that can be overlooked. Depending on the type of claim asserted, there are a variety of “coverage” options that may apply. I think the new fee disclosure rules are likely to increase claims for breach of fiduciary duty in the future, but even without that development, it makes sense to at least know whether you have coverage and what your options are. So let’s take a look at some of the options.
Posted By cmonfils on January 24, 2012
WASHINGTON — The Obama administration said Thursday that rate increases sought by a health insurance company were unreasonable, and it ordered the insurer to rescind them or justify its refusal to do so.
Kathleen Sebelius, the secretary of health and human services, issued the finding against the carrier, Trustmark Life Insurance Company, a unit of Trustmark Mutual Holding Company.
Posted By cmonfils on January 24, 2012
In a cavernous room just east of San Francisco, an army of phone operators fields calls from their customers. A large computer screen blinks the number of people on hold: two, and the average wait time: one minute, 12 seconds.
These phone operators working in a non-descript office park in Alameda are employed by a large health insurance plan, and they’re willing to go the extra mile for their customers. They’ll schedule a doctor to come to your home, a pharmacist to drop off a prescription, and they’ll even help you fill out an application for food stamps.
Posted By cmonfils on January 24, 2012
Under the Patient Protection and Affordable Care Act (ACA) passed by Congress, most Americans will be required to be covered by health insurance or pay a penalty—the so-called individual mandate. The legality of this feature is being debated in the courts.
These Urban Institute authors estimate the effects of the ACA and the individual mandate, as well as various levels of exchange participation, using a model that simulates decisions of individuals and businesses in response to policy changes. Exchange enrollment is viewed as necessary to reduce adverse selection, or the likelihood of only the sickest choosing to be insured.
Posted By cmonfils on January 24, 2012
A new state law allows Franklin County to reactivate its wellness programs in hopes of lowering health-care costs paid by taxpayers.
Legislation signed by Gov. John Kasich in late December clears up what some county prosecutors said was cloudy language regarding whether counties can create programs to combat obesity, high blood pressure, diabetes and heart disease. The law takes effect 90 days after signing.
Posted By cmonfils on January 24, 2012
The Patient Protection and Affordable Care Act of 2010 (ACA) is arguably the most significant health legislation enacted in generations. As remarkable a political and policy achievement as it was, what the reform will actually accomplish is largely yet to be determined. Whether it slows the growth of costs, increases access to care, or improves the quality of care will depend on how it is implemented. Although major components of the law do not go into effect until 2014, the fate of the ACA depends on the outcome of four key events in 2012.
Posted By cmonfils on January 24, 2012
More than 480 state lawmakers plan to file a brief Thursday urging the Supreme Court to uphold President Obama’s healthcare law.
The group includes at least one lawmaker from every state, including the 26 states whose attorneys general are suing to overturn the healthcare law’s individual insurance mandate. The Supreme Court is scheduled to hear oral arguments in March and will likely rule on the law this summer.
Posted By cmonfils on January 24, 2012
Surveys say corporate wellness programs seem to be resurfacing as a health trend in 2012, but what exactly do they entail?
The initiatives seem to be as diverse as the companies themselves, often depending on the size of the business. Some have in-house programs tied to health insurance and financial incentives, while others have gyms in offices or work with fitness clubs for discounted group memberships
Posted By cmonfils on January 24, 2012
from Spencer’s Benefits Reports: Uniform rate setting for medical provider payments offers the greatest health care cost growth containment potential, a recent study from the Urban Institute’s Health Policy Center found. The report noted that from 2000 to 2010, national health expenditures (NHE) have risen at an average annual rate of 6.6 percent, while gross domestic product (GDP) has grown only 4.1 percent annually. The Patient Protection and Affordable Care Act (ACA) contains a number of cost growth containment provisions, which the Urban Institute reviews in the report, Containing the Growth of Spending in the U.S. Health System, along with several other options, and estimates potential savings the options may provide.
Posted By cmonfils on January 24, 2012
The vaunted Geisinger Health System in central Pennsylvania ushered in the new year by becoming the latest employer to resolve not to hire smokers.
Posted By cmonfils on January 23, 2012
MyHealthGuide Source: Jerry Geisel,
Google Receives Approval
WASHINGTON–Google Inc. has received tentative Labor Department authorization to fund several benefit risks through its Hawaii captive insurance company. (more…)
